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

Patient Training and Safety with Home HD

Despite the paramount importance of safety with home HD, there is “a surprising lack of literature” about it and no consensus on optimal training techniques or schedules, contend the authors of a new study.

Read the abstract » | (added 2024-01-17)

Tags: Home HD, Training Techniques, Home HD Training Schedules

Progression of Brain Atrophy in PD vs. HD

A follow-up study of brain atrophy progression followed 73 PD and 34 HD patients who had brain MRIs, including 42 PD and 25 HD patients who had a second brain MRI. Brain grey matter volume measurement demonstrated faster progression of brain atrophy in PD than in HD, independent of potential confounders.

Read the abstract » | (added 2024-01-17)

Tags: Brain Atrophy, PD, HD

Is Wearable HD Moving Forward?

A review article contends that wearable kidney replacement will “radically reshape the landscape of kidney replacement therapies and have the potential to dramatically improve the lives of individuals living with kidney failure.” Great, but when?

Read the abstract » | (added 2024-01-17)

Tags: Wearable Kidney Replacement, Kidney Replacement Therapies, Quality Of Life

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

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

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

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

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