Journal Watch
Some WILL Choose More Intensive HD—If They Learn the Benefits
In the UK, a new study of 183 in-center HD patients finds that 60+% would consider doing 4 treatments per week or 4.5 hours per treatment. Information about longer survival, better quality of life, and fewer fluid limits and access complications were all significantly linked with choosing longer and/or more frequent treatments.
Read the abstract » | (added 2022-06-10)
Surprise Supplement Reduced Risk of Peritonitis on PD
Does correction of hypokalemia with potassium supplementation impact peritonitis rates? Yes, finds a new randomized controlled trial of 167 PD patients with hypokalemia from six clinics. Compared to conventional potassium management, use of a protocol aimed at maintaining potassium levels at 4-5mEq/L significantly extended time to first peritonitis.
Read the abstract » | (added 2022-06-10)
Risk of Left Ventricular Hypertrophy Tied to Fluid Overload on PD
A single hospital had 226 enrolled PD patients between late 2018 and January 2021. Using bioimpedance analysis and cardiac color Doppler ultrasound, patients were divided into an LVF and a non-LVF group, and into a normal volume and overhydration group. Of participants, 125 (55.3%) had LVH. Overhydration and low hemoglobin levels were independent risk factors for LVH.
Read the abstract » | (added 2022-06-10)
Tags: PD, LVH, Overhydration, Volume Loads
Urgent Start PD Takes on Urgent Start HD—Which One Wins?
A new meta-analysis examines survival vs. urgent start HD (which is experienced by an estimated 50%-60% of U.S. dialyzors). Pooled data from seven studies identified “a statistically significant reduced risk of all-cause mortality in patients undergoing urgent-start PD as compared to urgent-start HD.” While infectious complications did not differ, there was a significantly reduced risk of mechanical complications with PD.
Read the abstract » | (added 2022-05-12)
Tags: Urgent Start PD, Urgent Start HD, Survival, All cause Mortality, Mechanical Complications
Home-to-Home Dialysis Transition
When PD or home HD do not work out, people tend to end up in-center. In one clinic, of 911 home dialysis patients with technique failure, just 28 made a home-to-home transition over a 24-year period. Technique and patient survival were comparable, though hospitalizations and temporary in-center HD were common.
Read the abstract » | (added 2022-05-12)
Tags: Home Dialysis, In center, Technique Failure, Home to home Transition
Early Data from the Physidia Home HD Machine
The Physicia S3 is a new home HD machine in France that uses bagged fluid. A new proof-of-concept study enrolled 13 training centers and analyzed data from 80 patients and 249 treatment sessions. Dialysis dose, anemia, nutrition, and electrolytes were all adequately controlled.
Read the abstract » | (added 2022-05-12)
Tags: Physicia S3, Bagged Fluid, End stage Kidney Disease, Portable Artificial Kidney
Meta-analysis of Omental Procedures with PD Catheter Placement
Should removal (omentectomy) or fixation in place (omentopexy) of the curtain of omentum tissue be routine when a PD catheter is placed? In 15 studies (with low-to-moderate evidence), omental procedures reduced the risk of a need to remove the PD catheter. There were no differences in catheter malposition, migration, or peritonitis.
Read the abstract » | (added 2022-05-12)
Tags: Omentectomy, Omentopexy, Omentum Tissue, PD Catheter, Catheter Malposition, Migration, Peritonitis
PD Reduced Hospitalization 24% vs. In-center HD with a Catheter
In an 18-month retrospective study, 717 PD patients were matched 1:1 with in-center HD patients using central venous catheters. The matching also included cause of ESKD, race, diabetes status, and insurance. The hospitalization rate was 24% lower for those on PD, and mortality was 15% lower.
Read the abstract » | (added 2022-04-18)
Tags: PD, In center HD, Catheters, Cause Of ESKD, Race, Diabetes Status, Insurance, Hospitalization Rate, Mortality
The Impact of Vitamin D Levels on Quality of Life in PD
Fifty people on PD were divided into a normal vitamin D (>20 ng/mL) and a deficient vitamin D group (<20 ng/mL), and both groups took the KDQOL-36 quality of life questionnaire. All subscales of the KDQOL-36 were significantly lower in the vitamin D deficient group.
Read the abstract » | (added 2022-04-18)
Can People do Urgent Start PD and Intermittent PD?
Yes. Among 169 people starting PD urgently, 111 had fewer than four exchanges per day (intermittent) and 58 received full-dose PD. A year later, both groups had adequate PD and similar peritoneal transport, residual kidney function, blood pressure control, anemia management, and correction of bone minerals. Infections, complications, and technique survival were similar as well.
Read the abstract » | (added 2022-04-18)
Tags: Urgent Start PD, Incremental Peritoneal Dialysis, USPD, IPD