Journal Watch
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U.S. PD Outcome Trends: 2009 to 2018
A USRDS analysis of data from 101,640 incident PD patients found a decrease in overall mortality from 11% (2009) to 8.4% (2018). The probability of switching to in-center HD a year after PD initiation also dropped by about 2% in patients under 75 years old.
Read the abstract » | (added 2025-07-16)
Tags: Chronic Dialysis, Incident PD , Mortality, Peritoneal Dialysis, Clinical Epidemiology
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BMI, Diabetes, and Mortality: HD and PD Differ
Among 3,235 patients with diabetes on dialysis followed for 3.9 + 3.5 years, most (2,452) were on HD, with 783 on PD. During the study, 53% (1,688) patients died (1,275: HD; 413: PD). In HD patients, mortality risk was higher in those with BMIs <18.5 kg/m2 and lower when BMI ranged from 25.1 to 40 kg/m2. No relationship was found between BMI and mortality risk on PD.
Read the abstract » | (added 2025-06-11)
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Expanded HD (HDx) vs. Online Hemodiafiltration (HDF)
A systematic review and meta-analysis of eight studies (n=614) compared HDx and HDF. While there was no statistical difference in all-cause mortality, creatinine, phosphate, or urea clearance, HDF did significantly reduce β2-microglobulin.
Read the abstract » | (added 2025-05-20)
Tags: HDx, HDF, Middle molecule Clearance
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Laparoscopic vs. Open PD Catheter Placement
Analysis of 11,731 PD catheter insertions from 2013 to 2018 examined the association between type of placement, complications, length of hospital stay, and mortality. During the 5-year period there was a significant increase in laparoscopic PD insertions. Complications were similar between groups, with slightly longer hospital stays for open placements.
Read the abstract » | (added 2025-03-13)
Tags: PD Catheter, Complications, Laparoscopic PD Insertions
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Impact of PD Exchange Volume/Day on Outcomes
A DOPPS cohort study in Japan divided patients into two groups by daily PD dialysate volume (<4L/day; n=98 or >4L/day; n=244). Despite demographic differences between the groups, there were no significant differences in transfers to HD, mortality, hospitalization, peritonitis, or patient-reported outcomes based on volume—thus less volume may be more cost effective.
Read the abstract » | (added 2024-12-11)
Tags: Dialysate Volume, Peritoneal Dialysis Outcomes, Mortality, Patient reported Outcomes
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Value of Remote Monitoring of PD
A cluster-randomized trial assigned 21 hospitals with automated PD (APD) programs to either do remote monitored (RM-APD; 10 hospitals) or conventional APD (11 hospitals) for 398 adult patients initiating PD. In the conventional APD group, all-cause mortality, cardiovascular deaths, and hospitalizations were significantly higher, as were PD dropouts and adverse events and hospitalizations related to cardiovascular disease, fluid overload, or poor PD adequacy.
Read the abstract » | (added 2024-09-12)
Tags: Automated PD, APD, All cause Mortality, Cardiovascular Deaths, Hospitalizations, Cardiovascular Disease, Fluid Overload, PD Adequacy
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Which is Safer: Urgent Start HD or Urgent Start PD?
Analysis of data from 9 studies (941 PD and 779 HD patients) revealed that the risk of all-cause mortality, dialysis-related infections, and mechanical complications were higher in patients who started HD urgently than in those who started PD urgently.
Read the abstract » | (added 2024-07-12)
Tags: PD, HD, All cause Mortality, Dialysis related Infections, Mechanical Complications, Urgent start
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Home HD, Self-cannulation, and Survival
An observational study of all home HD patients at a single center from 2001 to 2020 examined treatment survival and mortality. Among 77 self-cannulating patients dialyzing for a median of 18 hours per week, there were 11 deaths, largely cardiovascular, and 19 technique failures after 100 months, largely due to vascular access issues.
Read the abstract » | (added 2024-06-14)
Tags: Home HD, Self Cannulation, Treatment Survival, Mortality, Cardiovascular, Technique Failure, Vascular Access
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Management of PD Anemia in Japan
Should people who use PD have the same hemoglobin (hb) targets as those who do HD? Researchers analyzed registry data of 4,875 patients 18 or older who were doing PD at the end of 2012 and compared their hb levels with mortality for the 1,586 who died. In a U-shaped curve, hb levels < 9.0 and > 13.0 were significantly associated with death. In those who had a history of cardiovascular disease, hb levels > 12.0 were significantly associated with death.
Read the abstract » | (added 2024-06-14)
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Mineral Bone Disease (MBD) and Survival on PD
A P-DOPPS study analyzed MBD data from more than 12,000 patients from eight countries. The results revealed a U-shaped curve for the relationship between PTH and mortality, with the lowest risk at PTH levels of 300-599 pg/mL. Serum calcium levels higher than 9.6 mg/dL were associated with a 20% increase in mortality as well. Major country variations in MBD treatment were identified.
Read the abstract » | (added 2024-04-12)
Tags: Mineral Bone Disease, MBD, PTH, Mortality, Serum Calcium Levels, PD