Journal Watch - Prospective

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  1. PD—Controlling Volume to Reach Normal Hydration Protects the Heart

    Reanalysis of data from a multicenter, prospective, randomized controlled trial looked at fluid control in PD in 151 patients followed for a year. While most (120) reached normal hydration levels as measured by bioimpedance analysis, those who did not had significantly higher left atrial diameter—and a lower left ventricular ejection fraction at the end of the study.

    Read the abstract » | (added 12/10/2019)

    Tags: Fluid Management, Cardiovascular Risk, Pd, Peritoneal Dialysis, Bioimpedance Spectroscopy

  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. Higher Serum Albumin May Protect Residual Kidney Function in PD

    In a prospective study of 104 new PD patients, having low serum albumin levels was independently associated with complete RKF loss (<100 mL/day of urine).

    Read the abstract » | (added 06/13/2019)

    Tags: Serum Albumin, Residual Kidney Function, Urine Volume, Peritoneal Dialysis, Pd

  4. Cognitive Impairment Predicts PD Peritonitis

    A prospective cohort study assigned 458 PD patients to a cognitively impaired (CI) or non-CI group based on results of mental state testing. The groups were not otherwise significantly different. Over 31.4 (median) months, 94 patients had first-time peritonitis, and short-term memory losses were independently linked with a higher risk.

    Read the abstract » | (added 04/11/2019)

    Tags: Cognitive Impairment, Mental State, Peritonitis

  5. Lower Dementia Risk with PD than Standard In-Center HD: Metaanalysis

    An analysis of 15 studies concludes that PD is associated with a lower risk of cognitive decline and dementia than HD--but calls for well-conducted prospective studies.

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

    Tags: Dementia, Pd, In Center Hd, Cognitive Functions

  6. 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

  7. Medicare Reimbursement Has Driven More PD

    Changes to the Medicare Prospective Payment System (PPS) in 2011 to create financial incentives for PD have worked, finds a new analysis of 6,433 dialysis clinics before and after the change. Since 2011, 6% more clinics offered PD, and program size increased from an average of 5.7 patients to 6.9. Non-urban, chain, and larger clinics were significantly more likely to have changed their PD practices in response to the PPS change.

    Read the abstract » | (added 12/14/2018)

    Tags: Medicare, Prospective Payment System, Peritoneal Dialysis, Quality Of Life

  8. Metaanalysis of Nocturnal HD and Sleep Quality

    Nine studies of 286 patients found significantly less sleep apnea and better O2 saturation—but less total sleep time—after switching from conventional to nocturnal HD. Prospective pre-post studies found improved sleep quality, but randomized trials did not. Read the abstract.

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

    Tags: Sleep Apnea, Chd, Nhd, O2 Saturation, Nocturnal Hd, Conventional Hd, Sleep Quality

  9. What Makes Home HD Patients Reach for On-Call Support?

    A 4-month prospective observational study analyzed the reasons why 58 home HD patients called the on-call nurse or technician. Most calls to nurses were made for clinical issues or machine set-up or alarm questions, some of which required a technician. Most of the technician calls were for machine malfunction, set-up and alarms, or water treatment. Read the abstract.

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

    Tags: Home Hemodialysis, Independent Hemodialysis, Nocturnal Hemodialysis, Short Daily Hemodialysis

  10. Blood Flow Rates and Clinically Meaningful Solute Removal

    A prospective study of 17 patients looked at BFRs of 300, 350, and 450 and Kt/V urea, beta-2 microglobulin, and phosphorus when low dialysate flow rates were used. While Kt/V did increase, the impact on B2M and phosphorus were minimal.

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

    Tags: Daily Hemodialysis, Home Hemodialysis, Kt/V, Blood Flow