Journal Watch
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HD Dose and Patient Survival: More is Better
Even using spKt/V—a flawed measure that considers only urea—a study of 558 standard HD patients from 2015 to 2020, of whom 214 died, found that a higher dose of dialysis reduced the risk of all-cause mortality by 33%.
Read the abstract » | (added 2022-09-13)
Tags: HD Dose, Dialysis Dose, Patient Survival, All cause Mortality
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Too-high OR Too-low LDL Cholesterol and Survival on PD
A retrospective study in China looked at data from 3,565 people starting PD from 2005 to 2020. Both higher and lower levels of LDL-C were linked with higher all-cause and cardiovascular mortality. Malnutrition and low LDL-C was especially risky.
Read the abstract » | (added 2022-08-11)
Tags: PD, LDL C, Cardiovascular Mortality, All cause Mortality, Malnutrition
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Structured CKD Education More Than Tripled Uptake of Home Therapies
In a matched retrospective cohort study, 2,398 CKD patients who attended a single 90-minute education program were pair-matched with others who did not. Compared to controls, those who attended the session were significantly more likely to be doing home dialysis (38.5% vs. 12.6%) and to be using a permanent access (57.9% vs. 33.8%). Hospitalization rates were 38% lower as well, and education-attendees had lower first-year mortality.
Read the abstract » | (added 2022-07-13)
Tags: CKD, Education Program, Home Dialysis, Permanent Access, Hospitalization Rates, First year Mortality
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Fatigue at PD Start Linked with Higher Mortality
A PLOS One study compared 4,285 incident PD patients who completed a KDQOL-SF vitality scale from Brazil (1,388) and the U.S. (2,897) from 2004 to 2011. Lower vitality scores after 90 days of PD were linked with a higher risk of mortality in both countries
Read the abstract » | (added 2022-07-13)
Tags: Fatigue, Incident Peritoneal Dialysis, Vitality, Mortality
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In Which Countries Do People Stay on PD Longer?
The Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) analyzed time on PD among 218 randomly chosen clinics and 7,121 patients in seven countries including the U.S. Median time on PD ranged from 1.7 years in the UK to 3.2 years in Japan and Thailand. PD mortality risk was higher in Thailand and the U.S., and infection was the leading cause of transfers to HD.
Read the abstract » | (added 2022-06-10)
Tags: Peritoneal Dialysis Outcomes And Practice Patterns Study, PDOPPS, PD, Mortality, Hemodialysis Transfer, Kidney Transplantation
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Urgent Start PD Takes on Urgent Start HD—Which One Wins?
A new meta-analysis examines survival vs. urgent start HD (which is experienced by an estimated 50%-60% of U.S. dialyzors). Pooled data from seven studies identified “a statistically significant reduced risk of all-cause mortality in patients undergoing urgent-start PD as compared to urgent-start HD.” While infectious complications did not differ, there was a significantly reduced risk of mechanical complications with PD.
Read the abstract » | (added 2022-05-12)
Tags: Urgent Start PD, Urgent Start HD, Survival, All cause Mortality, Mechanical Complications
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PD Reduced Hospitalization 24% vs. In-center HD with a Catheter
In an 18-month retrospective study, 717 PD patients were matched 1:1 with in-center HD patients using central venous catheters. The matching also included cause of ESKD, race, diabetes status, and insurance. The hospitalization rate was 24% lower for those on PD, and mortality was 15% lower.
Read the abstract » | (added 2022-04-18)
Tags: PD, In center HD, Catheters, Cause Of ESKD, Race, Diabetes Status, Insurance, Hospitalization Rate, Mortality
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Poorer Survival for Those Who Switch from Home to In-center HD
Among 19,306 people who started HD in the ANZDATA registry from 2005 to 2015 and were treated for more than 90 days, those who started home HD and then went to in-center HD had significantly higher mortality than those who stayed at home. The reasons for this are not yet known.
Read the abstract » | (added 2021-08-12)
Tags: HD, Home HD, In center HD, Mortality, Home Hemodialysis Treatment Failure
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The impact of low magnesium levels on heart disease deaths on PD
Hypomagnesemia is linked with all-cause mortality in HD—but, what about PD? A study classed 1,004 blood tests from PD patients measuring magnesium into one of three groups: <0.7 mmol/L, 0.7-1.2 mmol/L, and >1.2 mmol/L. Those in the lowest magnesium group did have a higher risk of death from both heart and non-heart causes.
Read the abstract » | (added 2021-05-14)
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Better Technique Survival with Assisted PD
A study of 384 PD patients in China compared the outcomes of 274 who did self-care PD with 110 who had assisted PD. Older age, diabetes, low residual kidney function and low serum albumin predicted higher mortality, as did assisted PD, since this group had more comorbidities. Technique failure was also significantly lower in the assisted PD group.
Read the abstract » | (added 2021-04-16)