Journal Watch
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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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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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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
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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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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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Steady Glucose Concentration in PD and Sodium Removal
In a small pilot study (n=8), two fast-average and six fast transporters used a standard 4-hour CAPD dwell as a control, and three 5-hour steady-concentration treatments using the Carry Life® UF device following an overnight icodextrin fill as the intervention. UF rates were significantly higher with the steady glucose concentration treatments, as were sodium removal and glucose UF efficiency.
Read the abstract » | (added 2023-11-15)
Tags: PD, Glucose Concentration, Sodium Removal
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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)
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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
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Rate of Residual Kidney Function Decline and Mortality in PD
When 497 PD patients were divided into two groups based on RRF decline value, those in the fast-decline group had significantly higher rates of all-cause and cardiovascular mortality. In fact, each 0.1mL/min/1.73m2 per month drop in RRF in the first year of PD predicted a 19% higher risk of all-cause mortality and a 20% higher risk of cardiovascular mortality.
Read the abstract » | (added 2023-11-15)
Tags: Rate Of Residual Kidney Function Decline, All cause Mortality, Cardiovascular Mortality
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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