Journal Watch
Do More Hours of HD Benefit Older Patients, Too?
Analysis of ANZDATA registry data of patients who started dialysis at age 65 and older from 2005 to 2015 say YES—hours of HD do matter to survival. Among 8,224 people, those whose HD sessions were 5 hours or longer had an 81% reduction in the hazard risk of death vs. those who only got 4-4.5 hour treatments (p < .001).
Read the abstract » | (added 2023-02-13)
Tags: HD, ANZDATA, HD Hours, Session Length, Survival Rate
44 Years of Home HD Technique Survival in Valencia, Spain
In Valencia, 13.4% of patients on dialysis were using home HD in 2018. Researchers compared home HD data from two eras: “ancient” (1976-2000) and “modern” (2001-2020). Interestingly, 1- and 2-year patient survival were superior in the modern era (87.3% vs. 83.7% for 1-year; 83% vs. 77.4% for 2-year)—but 5-year survival was better in the ancient era (61% vs. 47.8%), as patients aged. Technique survival was better at every point in the modern era.
Read the abstract » | (added 2023-02-13)
A Safety Framework to Address Risk Factors for Home HD Dropout
In an effort to pre-emptively identify and reduce drop out risks from a new home HD program, a clinic in Singapore undertook failure mode and effects analysis (FMEA). They listed each key process and sub-process, scored them for failure mode, and designed solutions. The transition from in-center to home HD was found to have the highest failure risk, in 59 areas, so two teams with different clinical experience developed a safety framework.
Read the abstract » | (added 2023-01-10)
Tags: Home HD, Risk Factors, Drop Out Risk, Failure Mode And Effects Analysis, Safety Framework
Video-based vs. Traditional PD Training: Which is Better
PD could be expanded more quickly if training did not have to be done one-on-one in person. In Italy, Videodialysis has been used since 2016 for remote patient and care partner training, after an initial home visit. In a small series (46 trainings; 21 at home and 25 by video), the video technique was found to be as effective as traditional training with fewer home visits.
Read the abstract » | (added 2023-01-10)
Tags: PD Training, Videodialysis, Home Visits, Telemedicine
New PD Prescription Core Curriculum Update for 2023
Individualizing PD to align with patient lifestyle preferences should take precedence over small solute clearance targets, say global PD experts.
Read the abstract » | (added 2023-01-10)
Tags: Individualized PD, Patient Lifestyle, Solute Clearance, PD Prescription
Frequency of Sexual Dysfunction on PD
A study enrolled 201 people who did CAPD for 3+ months (49 females and 65 males), with slightly more than half (n=114) under age 65). Gender-appropriate surveys administered in person, along with the SF-36 and Beck Depression Inventory (BDI) revealed that almost 90% of women and almost 88% of men reported sexual dysfunction. Depression was highly prevalent as well. The authors concluded that not discussing and treating sexual dysfunction could adversely affect quality of life.
Read the abstract » | (added 2023-01-10)
Tags: CAPD, Depression, Sexual Dysfunction, Quality Of Life
Do Pets Boost the Risk of Peritonitis on PD? A DOPPS Study
Surprisingly, the answer was no. Among 3,655 PD patients from eight country followed for a median of 14 months (55,475 patient months), the peritonitis rate was 0.29 episodes per year, with no increased risk for pet ownership—except in households with both cats and dogs, where the risk was 45% higher.
Read the abstract » | (added 2023-01-10)
Tags: Pets, Peritonitis, PD, DOPPS
Incremental PD (IPD) and Preservation of Residual Kidney Function
A single-center, retrospective study of IPD vs. standard PD (SPD) examined data from 87 patients, about 2/3 on IPD, with a median follow up of 23 months. IPD was associated with longer technique survival and significantly higher GFRs at 6 months and after 24 months.
Read the abstract » | (added 2022-12-19)
Tags: Incremental PD, IPD, Residual Kidney Function, Technique Survival
Serum albumin at 1 Year Predicts Long-term CAPD Outcomes
Among 436 patients using CAPD and followed for at least a year (48.25 + 24.05 months), each 1 g/dL increase in serum albumin at 1 year after PD start reduced the risk of death by 8.7%.
Read the abstract » | (added 2022-12-19)
Tags: Peritoneal Dialysis , Serum Albumin, CAPD, Mortality
Home HD Begins in Mainland China
Intrigued by observational studies suggesting better survival for home HD than in-center HD or PD—and reduced COVID exposure—a clinic in China established a training center and enrolled six patients. Patients were monitored by home visits, online, and by outpatient services. After an average of 16 months of training, three patients began independent dialysis at home, with no serious adverse events. Blood levels remained stable.
Read the abstract » | (added 2022-12-19)
Tags: Home HD, In center HD, PD, Infection, Mainland China