Journal Watch

  • International Use of PD

    Worldwide PD use is approximately 11%, which varies across the globe, finds a new survey of stakeholders in 182 countries (with 313 respondents from 160 countries). Median PD use was 38.1 per million. Thirty countries, mainly low-income, did not offer PD, while in 69% of countries, PD was the first modality for <10% of incident patients. The range of PD costs passed on to patients was 1-25%, with higher co-pays in South Asia and low-income countries. Patient-reported PD outcomes were rarely measured.

    Read the abstract » | (added 2020-09-11)

  • International Use of HD—Including Home HD

    A new survey of stakeholders in 182 countries (with respondents from 160 countries) found a use rate for HD of 298.4 per million. Among incident dialysis patients, the HD rate was 98.0. Standard in-center HD was available among 27% of low-income countries (and these patients paid more of the costs); home HD was available in 36% of high-income countries. Monitoring of patient-reported outcomes was done in 61% of countries, while 60% monitored bone minerals and patient survival, and 51% monitored technique survival. Just 5% of countries initiated patients on HD with arteriovenous access.

    Read the abstract » | (added 2020-09-11)

  • Aspergillus Peritonitis Review

    Compared to other fungal peritonitis, colonization with aspergillus is more dangerous, and identification is still a challenge. Among 55 cases reported in the literature between 1968 and 2019, the mortality rate was 38.3%, 85.5% had to have their PD catheter removed, and 81.8% of patients had to switch to HD.

    Read the abstract » | (added 2020-09-11)

  • PD and Bone Mineral Disorders vs. HD

    Body composition, nutritional status, DEXA, and bone mineral disease (BMD) biomarkers were assessed at baseline and one year in 242 ESRD patients starting either PD (n=138) or HD (n=104). Among HD patients, BMD decreased significantly—but not in PD patients. Preservation of BMD was associated with significantly lower all-cause mortality, with cortical bone preservation more predictive than trabecular bone preservation.

    Read the abstract » | (added 2020-09-11)

  • PD vs. Standard HD for Cognitive Function

    A metaanalysis of papers including 195,774 patients looked at whether PD or standard in-center HD better supported cognitive function. The authors found significantly less risk of cognitive impairment among those who did PD.

    Read the abstract » | (added 2020-09-11)

  • SARS-CoV-2 in PD Effluent

    Analysis of bodily fluids from 3 SARS-CoV-2-infected PD patients found that, while viral load was quite high in nasopharyngeal swabs, none of the PD effluent tested positive, even after dialysate concentration. This suggests that the risk of virus transmission from used PD fluid may be low.

    Read the abstract » | (added 2020-09-11)

  • Benefits of PD Remote Monitoring

    A retrospective study compared two groups of APD patients, one that received remote monitoring (n=38) and one that received routine care (n=35). PD dropout and fluid status were similar between the two groups. But, the remote monitoring group had fewer ER and hospital visits related to kidney disease, especially among those with more comorbidities. Patients also preferred remote monitoring, and were more satisified with their care.

    Read the abstract » | (added 2020-09-11)

  • Impact of Depression on PD Patient and Technique Survival

    Among 275 patients who had done CAPD for at least 3 months, 31.3% tested as having depressive symptoms. Long-term patient and technique survival were significantly poorer in this group, even adjusting for cofounders.

    Read the abstract » | (added 2020-09-11)

  • Advantages of PD in Primary Glomerulonephritis (PGN)

    A prospective observational study followed all incident PD patients (n=2,243) who had PGN in the Levante registry from 1995 to 2014. Compared to other diagnoses, those with PGN had a significantly lower rate of peritonitis and better mean survival. The authors conclude that “PD has several advantages as a first dialytic treatment, and our results suggest that it is an excellent technique to manage patients with PGN while they await a kidney transplant.”

    Read the abstract » | (added 2020-09-11)

  • Converting In-center HD Patients to Home: the Importance of Belief

    A small, cross-sectional study (n=44) interviewed patients who were and were not considering home HD. Only 68% of patients said they’d heard about the benefits of home HD. The cohort who were willing to consider it were significantly more likely to believe that self-care and home HD would improve their quality of life, particularly travel, better health outcomes, and the comfort of being at home.

    Read the abstract » | (added 2020-09-11)