Journal Watch
Urgent-start PD in Brazil
In a prospective study, 51 patients who needed dialysis urgently began peritoneal dialysis instead of hemodialysis. Even with high-volume dialysate used less than 72 hours after catheter placement (on alternate days in the dialysis clinic), the option was feasible and safe. Read the abstract.
Read the abstract » | (added 2017-11-13)
Tags: Acute Peritoneal Dialysis, Unplanned Peritoneal Dialysis, Urgent start Dialysis, Urgent start Peritoneal Dialysis
More CMS Incentives Needed to Boost Home Dialysis
More CMS Incentives Needed to Boost Home Dialysis Have changes in the ESRD Prospective Payment System (“bundle”) designed to increase the use of home dialysis been successful? A new analysis of USRDS data from 2006 to 2013 found that bundling injectable medications and paying for home training did move the needle a bit—but not enough. Compared to patients with other insurance who had a 4.1% increase in home dialysis during this period, Medicare beneficiaries had a non-significant 5.8% rise.
Read the abstract » | (added 2017-10-13)
Tags: Education Issues: For Patients And Professionals, Choosing The Right Path Through ‘The System’
Waist Circumference Linked to Survival on PD
A prospective study of 109 people on PD measured waist circumference (WC) at baseline and at 6 months, then followed them for 4 years. At baseline, 55% of women had a high WC (>88cm) and 23% of men did (>102cm). After 6 months, The WC of 61% of participants had increased. High baseline WC and an increase were both associated with a higher risk of death.
Read the abstract » | (added 2017-06-12)
More Inflammation With Standard HD Than With PD
Inflammation can lead to heart damage and poor outcomes. Two 3-month prospective studies with 228 HD and 80 PD patients measured two markers of inflammation: CRP and IL-6. In HD patients, these levels were both higher and more variable than in PD.
Read the abstract » | (added 2016-06-08)
Tags: Hemodialysis
Using Plant-Protectant Resveratrol to Preserve the Peritoneum
Resveratrol is a phenol found in the skins of grapes and some berries that can help keep blood vessels from growing to support tumors. A new prospective, randomized, controlled, double blind study looked at its use to keep blood vessels from growing in the peritoneum, which can cause PD technique failure. Participants (n=72) were given 12 weeks of low- or high-dose resveratrol or placebo. Those who received a high dose of resveratrol had significantly better ultrafiltration.
Read the abstract » | (added 2016-01-10)
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PD Catheters: To Dress or Not to Dress?
Which is better for preventing exit site infections, a PD catheter dressing, or leaving a healed catheter open to the air? A prospective, randomized, controlled trial in Malaysia followed 108 patients for 2 years. All were instructed to wash the exit site daily with antibacterial soap. The dressing group (n=54) used povidone iodine, mupirocin ointment, sterile gauze, and tape. The non-dressing group did not. Of the 97 patients who completed the study, the results from both groups were similar.
Read the abstract » | (added 2015-10-15)
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Brazil APD Survival Significantly Better than CAPD
A prospective study matched each of the incident APD patients in Brazil with a CAPD patient, using 15 matching factors, and looked at mortality, technique failure, and time to first peritonitis. With 1,445 patients each in the APD and CAPD groups, the researchers found 44% higher mortality among CAPD patients, but no differences in technique failure or time to peritonitis.
Read the abstract » | (added 2015-08-08)
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Icodextrin reduces PD failure and boosts survival
In a prospective trial of 306 incident PD patients between 2007 and 2011, those who used icodextrin were significantly more likely to continue with PD and more likely to live longer than those who used standard PD fluid.
Read the abstract » | (added 2015-04-10)
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Is low blood sodium as harmful in PD as it is in HD?
Hyponatremia (low blood sodium levels) raise the risk of death in people who do standard in-center HD. A prospective observational study of 441 incident PD patients found a higher mortality risk among those who did PD, too. In fact, after 3 years, the 1/3 of study participants whose sodium was lowest had a 79% higher risk of death than those whose levels were higher.
Read the abstract » | (added 2014-12-09)
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Strict volume control on PD helps the arteries and heart
In a prospective observational study of 58 people on PD, there was no difference in echocardiogram findings between APD and CAPD. But, those who followed strict volume control had better blood pressure control, less arterial stiffness, and lower NT-pro-BNP levels (a marker of left ventricular function).
Read the abstract » | (added 2014-05-06)
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