Journal Watch
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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
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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
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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
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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
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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
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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
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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
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Hope, Quality of Life, and Psychoscial Distress in PD
Are people on PD hopeful? A study from China surveyed 134 people on PD, assessing their level of hope. Working patients with higher income using APD had higher hope scores, and hope correlated significantly with both age and social support. Higher hope scores were linked with better mental well-being and less severe depression.
Read the abstract » | (added 2023-11-15)
Tags: Hope, Quality Of Life, Psychoscial Distress In PD, Income, APD, Depression
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Home Dialysis and Psychological Health
An interview study of 36 people on PD (n=13) or home HD (n=7) and care partners identified four themes and subthemes, including isolation and disconnection, importance of support systems, burden of distress, and seeking mental health support.
Read the abstract » | (added 2023-11-15)
Tags: Isolation, Support Systems, Distress, Mental Health Support
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Surprising Impact of First Dialysis Modality on Survival in Patients with Diabetes
A retrospective cohort study of 739 patients from 2010 to 2018 (inclusive) used propensity score matching to compare mortality between standard HD and PD in China, matching 125 PD patients with HD patients. No significant differences were found—except in those with diabetes, who had significantly better survival with PD.
Read the abstract » | (added 2023-11-15)
Tags: Modality, Survival, Diabetes, Propensity Score Matching