Journal Watch - Peritoneal dialysis
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When to start PD after catheter placement
A new randomized controlled trial included 122 new PD starts at two Queensland, Australia hospitals for 5 years. Participants were randomized to three groups, who started PD at either 1 week, 2 weeks, or 4 weeks after PD catheter placement. Leaks were higher in the 1-week group, while PD technique failure was higher in the 4-week group.
Read the abstract » | (added 2017-05-09)
Tags: Peritoneal dialysis, Catheter
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Why and how to change the dialysis default to PD
PD is comparable to standard HD in outcomes, but costs less, is more convenient, does a better job of preserving residual kidney function, and delivers better quality of life, argues a new editorial.
Read the abstract » | (added 2017-05-09)
Tags: Peritoneal dialysis
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How dialysis clinics can help prevent peritonitis
What can dialysis clinics do to reduce the risk of peritonitis in PD patients? In an analysis of 127 PD clinics and 5,017 new PD patients, having a nurse who specialized in PD or conducting home visits prior to the PD start had the biggest impact.
Read the abstract » | (added 2017-05-09)
Tags: Peritoneal dialysis
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Pregnancy on PD—at 42: It’s Not Impossible
While research shows that the chance for a pregnant woman on dialysis to have a healthy baby seems to be best with 36+ hours of HD per week, a 42-year old Malaysian woman had a full-term baby with no change to her CAPD prescription.
Read the abstract » | (added 2017-04-12)
Tags: Peritoneal dialysis, Hemodialysis
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Striking Lack of Data on Infection Prevention in PD
A Cochrane database review of 59 randomized controlled studies revealed “striking” gaps in our knowledge about what really works to prevent infections in PD. Oral or topical antibiotics and topical disinfectants had uncertain benefits for exit site, tunnel infections, or peritonitis. Use of IV vancomycin prior to catheter placement may reduce the risk of early peritonitis. Antifungal treatments may reduce fungal peritonitis after antibiotics.
Read the abstract » | (added 2017-04-12)
Tags: Peritoneal dialysis
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PD vs. Standard HD for People with Cirrhosis
For cirrhotic people with kidney failure, data abstraction from the U.S. Nationwide Inpatient Study between 2005 and 2012 compared outcomes with PD and standard in-center HD. In-hospital mortality for those with ascites was significantly less with PD. In addition, PD hospital stays were shorter and costs were lower. Yet, just 1.7% of the sample was using PD.
Read the abstract » | (added 2017-04-12)
Tags: Peritoneal dialysis, Hemodialysis
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Serum Uric Acid Levels and PD Technique Failure
Among 371 people using CAPD in Taiwan , those with higher levels of uric acid in their blood were significantly more likely to have PD technique failure and peritonitis than those with lower levels.
Read the abstract » | (added 2017-04-12)
Tags: Peritoneal dialysis
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The Impact of Telehealth on PD Satisfaction
Per quarterly surveys completed by 200 people on PD, a system of telemedicine that included remote monitoring of blood pressure, weight, and glucose, and had educational videos boosted satisfaction with the option. Participants felt more autonomy and confidence in their health care, as well, and were less frustrated. Nearly half watched at least one video.
Read the abstract » | (added 2017-03-09)
Tags: Peritoneal dialysis
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PD and Serum Vitamin D—A Vital Link
People with no history of heart disease on PD for 3+ months were compared to age- and sex-matched healthy controls in a 24-month study of subclinical atherosclerosis. Those on PD had significantly more carotid and femoral plaques at baseline than controls. Lower levels of serum vitamin D predicted more plaque at baseline and at 24 months. The authors suggest that monitoring could help identify patients who are at higher risk.
Read the abstract » | (added 2017-03-09)
Tags: Peritoneal dialysis
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A New Approach for Treating Peritonitis in Patients Over Age 50
Researchers tried a new, 3-step “Mero-PerRest” protocol when patients over age 50 developed peritonitis due to enteric (gut) microorganisms. 1). Temporary “peritoneal rest” with the catheter in place. 2). IV meropenem. 3). Meropenum as a catheter lock. Compared to 203 bouts of peritonitis treated with usual care, 217 bouts treated with the new protocol had a higher primary cure rate (90% vs. 65.3%), better PD survival (90% vs. 64.9%), and similar patient survival.
Read the abstract » | (added 2017-02-08)
Tags: Peritoneal dialysis