Journal Watch
Urgent-start PD vs. Urgent-start HD: Meta-analysis
Analysis of data from nine studies looking at all-cause mortality found a rate of 0.173 for urgent-start PD vs. .214 for urgent-start HD. Those who started PD urgently had lower risks of infection-related death, bacteremia, and other complications, though rates of cardiovascular and cancer mortality were similar.
Read the abstract » | (added 2024-01-17)
Tags: All cause Mortality, Urgent start PD, Urgent start HD, Infection related Death, Bacteremia
Should We Drop PD “Adequacy” as a Measure?
New ISPD guidelines suggest that patient well-being should be the goal of the PD prescription, not target urea or creatinine clearances. Identification of solutes that cause uremic symptoms could help devise ways to limit their accumulation.
Read the abstract » | (added 2023-12-15)
Tags: ISPD Guidelines, Patient Well being, PD Prescription, Uremic Symptoms
Perhaps Prophylactic Omentectomy Should be Standard in Pediatric PD Patients
A meta-analysis of nine studies and 775 patients found significant reductions in catheter obstruction in children who had an omentectomy at the time of PD catheter placement. There was a trend toward reduced rates of PD catheter removal or reinsertion as well.
Read the abstract » | (added 2023-12-15)
Tags: Prophylactic Omentectomy, Pediatric PD, Catheter Obstruction
High Ultrafiltration Volumes May Contribute to Pruritus
Could changes in skin perfusion and inflammation play a role in dialysis itching? An observational study of 392 patients looked at self-reports of pruritus severity and UF volumes. BMI and UF volume independently predicted pruritis severity.
Read the abstract » | (added 2023-12-15)
Tags: Ultrafiltration Volume, UF Volume, BMI, Pruritus, Skin Perfusion, Inflammation
How Sugar Harms the Peritoneum and Causes Fibrosis
HOW does sugar harm the peritoneum? An RNA sequencing study looked at peritoneal endothelial cell (EC) function in mice and human ESRD cells in the presence or absence of glucose. In mice, glucose increased EC proliferation, permeability, and inflammation. Blocking glucose caused a therapeutic benefit. Human cells reacted in a similar way.
Read the abstract » | (added 2023-12-15)
Tags: Sugar, Glucose, Peritoneum, RNA Sequencing, Endothelial Cell Function
Lessons from Almost 15,000 PD Catheter Placements
Of the various PD catheter placement techniques, laparoscopy had higher 6-month mechanical complications, exit site infections, revision, and removal rates, while fluoroscopy had higher rates of sepsis and death. Open surgery had higher rates of catheter displacement.
Read the abstract » | (added 2023-12-15)
Tags: PD Catheter Placement Technique, Laparoscopy, Mechanical Complications, Exit Site Infections, Revision, Removal Rates, Fluoroscopy, Sepsis, Death
Dietary Protein Intake and Survival on PD
Among 668 stable PD patients followed for up to 13 years, quarterly 3-day dietary records were collected for 2 ½ years. Dietary protein intake greater than 0.8 g/Kg/day improved long-term survival.
Read the abstract » | (added 2023-12-15)
Tags: Dietary Protein, Survival, PD
A Home Dialysis Primer for Internists
Since PD and home HD are increasing in use due to their clinical and practical advantages, clinicians need to understand these treatments. A new primer in the Annual Review of Medicine will help them do just that.
Read the abstract » | (added 2023-12-15)
Tags: Home Dialysis, HD, PD, Home Dialysis Primer
The PD Surprise Question Predicts Transfer to HD
An observational study of 1,275 PD patients in 35 programs asking the RN and treating nephrologist, “Would you be surprised if this patient transferred to HD in the next 6 months?” identified 15% as high risk. After 6 months, the transfer to HD rate was nearly four times higher in the high risk group than the low risk group.
Read the abstract » | (added 2023-12-15)
Tags: PD, Home Dialysis, Peritoneal Dialysis, Surprise Question
How to Set Up New Home Dialysis Programs
More than half of U.S. dialysis clinics are either not licensed to train patients in PD or home HD, or are licensed but have no patients in their home programs. A new review article outlines the core domains needed to set up and run a home dialysis program in the U.S.
Read the abstract » | (added 2023-11-15)