Journal Watch - Outcomes

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  1. Home Dialysis: Better Outcomes at Lower Costs

    Five years after starting dialysis, the population of Ontario, Canada over age 18 had mean 30-day PD costs 50% lower than in-center HD—and home HD costs 64% lower than in-center. After adjusting for covariates, home HD cost the least and had the highest survival (80%) vs. 52% on PD and 42% on in-center HD.

    Read the abstract » | (added 10/14/2019)

    Tags: Home Dialysis, Pd Cost, Hd Cost, Hd Survival

  2. PD Outcomes under the Medicare Expanded Dialysis Prospective Payment System

    A Medicare change in 2011 may have increased the likelihood that clinics would expand PD to a broader population. Did this affect outcomes? A prospective cohort study compared 10,585 patients who started PD before payment reform, 7,832 interim patients, and 18,742 during the reform period. With similar demographics, more patients were treated in clinics with less PD experience—and these clinics had higher PD discontinuation rates. But, PD discontinuation fell overall, and mortality risk was stable.

    Read the abstract » | (added 10/14/2019)

    Tags: Expanded Dialysis Prospective Payment System, Pd, Medicare

  3. KDIGO Controversies: Dialysis Start and Modality Choice

    A January 2018 Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference addressed significant variations between countries in dialysis start, patient preparation, and modality mix. Happily, attendees supported individualized care that incorporates patient goals and preferences (within quality and safety parameters), and the need to avoid a one-size-fits-all approach.

    Read the abstract » | (added 05/15/2019)

    Tags: Modality, Individualized Care, Patient Goals, Patient Preferences

  4. Most Cost Effective Dialysis Options: Metaanalysis

    An analysis of 16 economic studies from both high- and low-income countries determined that home dialysis options are less costly and offer comparable—or better—health outcomes than in-center HD. Quality of life concerns were rarely investigated, however.

    Read the abstract » | (added 02/14/2019)

    Tags: Economic Studies, Hd, Cost, Dialysis Options, Health Outcomes

  5. Low-volume Tidal PD for Urgent Starts

    A randomized, prospective trial was done to see if tidal PD (TPD) would improve outcomes among 27 urgent start PD patients, vs. 22 who did low-volume intermittent PD. After follow up for up to 2 years, the TPD group did have significantly fewer catheter complications. Both options had about the same technique survival.

    Read the abstract » | (added 01/11/2019)

    Tags: Automated Peritoneal Dialysis, Tidal Peritoneal Dialysis, Intermittent Peritoneal Dialysis, Complications

  6. Urgent Start PD + Diabetes

    A retrospective study compared the first 30-day outcomes and survival trends of 80 urgent start dialysis patients, 50 of whom (62.5%) did PD. Compared to those who started standard in-center HD, the dialysis-related complications were significantly lower for those on PD, and PD survival was higher as well. Read the abstract.

    Read the abstract » | (added 10/12/2018)

    Tags: Diabetes, Survival Trends, Urgent Start Dialysis, Pd, In Center Hd, Dialysis Related Complications

  7. Metaanalysis of PD for Kidney Failure due to PKD

    Polycystic kidneys may displace room for PD fluid, so can PD be a viable treatment option? A metaanalysis of 12 studies and more than 17,000 patients found…maybe. PD outcomes were about the same for those with PKD as with other primary kidney diseases, and some can do PD. More research is needed to determine who is suitable. Read the abstract.

    Read the abstract » | (added 10/12/2018)

    Tags: Dialysis Adequacy, Pd Associated Complications, Peritoneal Dialysis, Polycystic Kidney Disease

  8. Nocturnal HD is Underused

    A new review suggests that the improved outcomes associated with more hours of HD in-center or at home mean that these options should be used more. Read the abstract.

    Read the abstract » | (added 09/10/2018)

    Tags: Extended Hours, Improved Outcomes, Hd, Nocturnal Dialysis, Quality Of Life

  9. PD Catheter Outcomes in Low vs. High-Volume Centers

    Not surprisingly, patients whose PD catheters were placed at high-volume centers (in Japan) had fewer adverse events, needed feer blood transfusions, and had shorter hospital stays than those from low-volume centers. Read the abstract.

    Read the abstract » | (added 09/10/2018)

    Tags: Pd, Catheter, Hospital Volume

  10. Home HD After PD Failure May Lead to More Transplants, Lower Mortality

    Since PD failure can lead to hospitalization and death in those who switch to standard in-center HD (ICHD), would outcomes improve with home HD? A new analysis found 521 patients in the USRDS data who made the change. Compared to matched ICHD patients, the chance of transplant was nearly double (21% vs. 10.6%), while survival of home HD patients was 89.1% at 1 year and 80.5% at 2 years.

    Read the abstract » | (added 08/13/2018)

    Tags: Pd Technique Failure, Ichd, Transplant, Home Hd, Lower Mortality