Journal Watch
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Heart Disease? PD is a Good Option
In a single clinic study, 112 new patients starting PD with or without heart disease were followed for 5 years. More people with heart disease had diabetes (53.3% vs. 31.7%), and they tended to be older. But, there were no differences between groups in hospital admissions, peritonitis, or PD technique failure.
Read the abstract » | (added 2017-02-08)
Tags: Peritoneal dialysis
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For HD Survival, Home Beats In-Center
An observational study looked back at 41 incident patients starting home HD and matched them to patients starting in-center HD by sex, age, comorbidity, and start date. Mean survival on home HD was 17.3 years, vs. 13 years in-center. Home HD patients also had significantly lower phosphate levels and did not require blood pressure medications.
Read the abstract » | (added 2016-07-12)
Tags: Hemodialysis
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Starting PD with Three Exchanges
Are four PD exchanges magical? Or could new patients thrive with three exchanges per day, at least for a while? In a new study, 46 incident PD patients began treatment with three exchanges. During the 2 years of the study, 25% received a kidney transplant. Most were able to use three exchanges for a mean of 24 months before needing a fourth, and there was less loss of residual kidney function than in the predialysis period prior.
Read the abstract » | (added 2016-05-12)
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Loss of Kidney Function Slowed After Starting PD
In 77 new PD patients, the rate of decline of kidney function was significantly slower after they started PD than it was when they were predialysis (p<0.01).
Read the abstract » | (added 2016-04-12)
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Survival on PD vs. Daily Home HD
A USRDS study matched 3,142 people starting daily home HD with 2,688 starting PD and compared survival. Those who were doing short daily HD had 12.7 deaths per 100 patient years, vs. 16.7 in the PD group.
Read the abstract » | (added 2016-04-12)
Tags: Hemodialysis
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Some PD Patients at Risk for New Onset Diabetes
Among 612 people who did not have diabetes, 32 were diagnosed with the disease after starting PD. The risk of new diabetes was higher in those who were older, had higher BMIs, and whose blood had more markers of inflammation.
Read the abstract » | (added 2016-02-09)
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How patients and care partners feel about home HD
A review of 24 qualitative studies of home HD patients and care partners found five themes: feeling vulnerable, fear of being alone, concerns about family burden, opportunity to thrive, and appreciating medical responsiveness. Starting home HD seemed to be an especially anxious time. Acknowledging these themes and offering reassurance may help more people succeed on home HD.
Read the abstract » | (added 2015-02-10)
Tags: Home dialysis
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Urgent-start PD: A how-to guide
Many nephrologists would choose PD for themselves. But few patients start on it, in part because ESRD may be found so late that dialysis is imminent. If only PD starts could be as done as easily as HD catheter placements... As it turns out, PD can be started on an urgent basis, and this approach is starting to pick up speed. This article reviews the literature, ways to overcome challenges, and the possible impact of changing the paradigm away from a default of standard in-center HD.
Read the abstract » | (added 2013-12-10)
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What are the challenges for successful home HD?
The UK has actually set a goal in 2002 for home HD of 10-15% of dialysis patients, but has not reached it yet. A new study (BASIC-HHD) is starting to look at the reasons for underuse of a treatment option that offers better results than standard in-center HD. A total of 500 patients will be followed, 200 pre-dialysis, 200 hospital HD, and 100 home HD from across the UK. The predialsyis patients will be followed for a year to better understand their journey to ESRD and renal replacement. They will be interviewed, take psychosocial assessments, and have blood tests. The researchers will also look at the attitudes and practices in dialysis clinics, the economics of home treatment, and care partner concerns.
Read the abstract » | (added 2013-10-02)
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Starting more people on PD does not cause harm
In Canada, a study looked at PD "attempt rates": how often each nephrologist would start new patients on PD. Between the highest and lowest attempt rates, there were no differences in PD success—or survival. The authors conclude that maximizing PD start rates can save money to help more people, with no harm to patients.
Read the abstract » | (added 2013-04-29)
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