Journal Watch
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Facilitating Home Hemodialysis Through Self-Cannulation
Needle phobia is highly prevalent among dialysis patients and is a significant barrier to home HD adoption. An updated comprehensive literature review and case study does a deep dive into factors contributing to needle phobia, physiological response to needle exposure, and techniques (pharmacological and non-pharmacological) to manage needle distress.
Read the abstract » | (added 2026-06-17)
Tags: Needle Phobia, Self Cannulation, HD Adoption
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The Impact of Seasonality in Home Dialysis Initiation and Hospitalization Rates
Analysis of data from 548,530 U.S. adults with fee-for-service Medicare who started home dialysis between 2007 and 2020 examined whether initiating dialysis in particular seasons affected hospitalizations. Dialysis initiation in the winter was more likely to be inpatient, had lower odds of receiving home dialysis within 12 months, and home dialysis use rates that remained low afterward. Inpatient dialysis initiation explained 40% of the association between season and home dialysis use, 77% of the 12-month figure, and 55% of the association between season and overall home dialysis use.
Read the abstract » | (added 2026-06-17)
Tags: Seasonality, Home Dialysis Initiation, Hospitalization Rates
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Backup AVFs in PD
A small (n=115) retrospective cohort study compared PD patients with and without a backup AVF (bAVF). There were no differences in mortality or transfer to HD between groups, but having a bAVF was linked with a lower HD transfer risk with a CVC. Complications were similar.
Read the abstract » | (added 2026-06-17)
Tags: Backup AVF, BAVF, Mortality, CVC, Transfer To HD
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Patient Employment Rates in PD vs. In-center HD (IHD)
A study followed 18,408 PD and IHD patients who were employed full-time at dialysis start and had employer health insurance for 3 to 30 months, while 104,952 PD and IHD patients who were unemployed and did not have employer insurance were followed as well. Patients receiving IHD were more likely than PD patients to lose their employer health plans.
Read the abstract » | (added 2026-05-15)
Tags: PD, IHD, Employment, Insurance, Health Plan
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Factors Driving Thirst in PD Patients
A cross-sectional study of 387 adult PD patients explored reasons for thirst and assessed thirst intensity, identifying a low-thirst group (n=121), a moderate thirst group (n=136), and a high thirst group (n=130), based on a visual analogue scale. Women tended to be more thirsty than men (p=0.03). Lower total weekly urea clearance and higher daily net sodium removal were also factors.
Read the abstract » | (added 2026-05-15)
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PD Comparable to HD for Patients with AKI
The choice of kidney replacement therapy (KRT) for AKI requiring dialysis is a modifiable factor that can impact outcomes. The comparative effectiveness of PD vs. HD in AKI is controversial. A systematic review and meta-analysis of seven studies compared mortality outcomes, recovery of kidney function, and infectious complications between PD and HD in patients with AKI. No significant mortality differences were found and kidney function recovery was similar between groups, though PD led to a significantly shorter time to kidney function recovery. Infection rates were also similar.
Read the abstract » | (added 2026-05-15)
Tags: Kidney Replacement Therapy, KRT, PD, AKI
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Bacterial Biofilm on PD Catheters
A retrospective study on PD patients from January 2007 to January 2024 looked at reasons for PD catheter removal, scanning electron microscopy results from removed catheters, and bacterial cultures from PD effluent. Patients either had catheter removal due to peritonitis or for other reasons. Peritonitis-caused catheter removal occurred after a significantly longer duration than the non-peritonitis group. Bacterial biofilm (cocci) was found in 71.4% of 28 patients; 90% of those who had peritonitis vs. 25% in the non-peritonitis group.
Read the abstract » | (added 2026-05-15)
Tags: Bacterial Biofilm, PD Catheters, Peritonitis
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Assessing Self-care Ability Prior to Dialysis Start Increases PD Use
A total of 263 patients with non-dialysis CKD and no contraindications to PD were randomized to an intervention group that received self-care competency assessment by a team of nephrologists, PD nurses, and a close family member, and a control group. The intervention group had a significantly higher rate of PD selection (54.6% vs. 38.3%).
Read the abstract » | (added 2026-05-15)
Tags: Self care Ability, CKD, PD
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Integrated Home Dialysis Programs and Hospitalization Risk
A Canadian Organ Replacement Register study compared hospitalization risk before, during, and after a PD to HHD transition (n=301) matched with HHD-first patients (n=711). The PD to HHD group had hospitalization rates up to 2.17 per patient year, mainly infectious, and predominantly in the year before the switch. Once on HHD, hospitalization risk tended to stabilize.
Read the abstract » | (added 2026-05-15)
Tags: Integrated Home Dialysis Programs, Hospitalization Risk, Organ Replacement, PD, HHD
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Alternative Quality Metrics for Kt/V-free PD
This article explores the historic origins of Kt/V and its adaptation to PD and the limitations of using urea removal as a surrogate for other uremic toxins. Are residual kidney and dialytic urea clearances equivalent? Is urea distribution volume accurate? The authors don’t think so! They propose a shift away from Kt/V and “adequacy” to person-centered care.
Read the abstract » | (added 2026-04-14)
Tags: Kt/V, PD, Urea Removal, Person centered Care