What We Don’t Know About Insulin Dosing for PD or HD Can Hurt Us

After 60 years of dialysis, we have a good sense of how to adjust insulin doses for PD and HD, right? Wrong. Even though diabetes is the leading cause of kidney failure, a systematic review of 11 articles found little information about insulin management.

Read the abstract » | (added 2022-02-14)

Tags: Insulin Dose, PD, HD, Insulin Management

Glycemic Variability and Survival in People with Diabetes on PD

A Swedish study divided 325 people with diabetes on PD into seven groups based on glycemic variability. Using the lowest variability group as a reference point, survival was significantly better with less variability in blood sugar.

Read the abstract » | (added 2022-02-14)

Tags: Diabetes, PD, Glycemic Variability, Survival, Blood Sugar

PD Helps Kidney Function Recovery

PD is known to help preserve residual kidney function. A study of 981 people on PD and 12,619 on HD in Taiwan looked at which option was more likely to help incident dialyzors recover function. Nearly 5% did recover their kidney function within 3 years—with a better chance for those who did PD.

Read the abstract » | (added 2022-02-14)

Tags: PD, HD, Kidney Function Recovery

Wound Vac Use Helpful for 7 Days After PD Catheter Placement

A new PD catheter is surrounded by an open wound. Among 30 people who had PD catheters placed, half were randomly assigned to receive negative pressure wound therapy (wound vac) for 7 days. The other half received conventional dressings. The exit site scores were significantly better in the wound vac group, and their exit sites remained significantly better for the next 6 months, though peritonitis rates were the same.

Read the abstract » | (added 2022-01-14)

Tags: PD Catheter, Catheter Exit site Care, Infection, Wound Vac

Incremental PD with Residual Kidney Function: Safe and Effective

Compared to 42 people who started full-dose PD, 54 who began incremental PD between 2015 and 2019 tended to be female, not have diabetes, and have more residual kidney function. PD technique survival, peritonitis, and hospitalization were about the same for both groups.

Read the abstract » | (added 2022-01-14)

Tags: Incremental PD, Residual Kidney Function, Full dose PD, Technique Survival

PD and Home HD in the U.S. vs. Canada

PD and home HD offer well-documented advantages and lower total costs in high-income countries. Both have seen growth in the US during the last decade, driven by payment changes and COVID-19—but US numbers still lag behind Canada and other countries.

Read the abstract » | (added 2022-01-14)

Tags: Peritoneal Dialysis, PD, Home Haemodialysis, HHD

Plastic vs. Metal Hemodialysis Needles: An International Nurse Survey

Plastic HD needles help prevent infiltration and hematomas, especially in elbow-located, new, or fragile fistulae—yet most countries continue to use cheaper metal needles. A nurse survey found strong resistance to plastic cannulae among respondents. Reduction in adverse access events may reduce costs, staff time, and patient distress.

Read the abstract » | (added 2022-01-14)

Tags: Plastic HD Needles, Plastic Cannulae, Infiltration, Hematomas

Cost of the Quanta SC+ in the UK

In the United Kingdom, in-center hemodialysis costs more than £36,350 per year, which includes patient transport. Annual costs for use of the SC+ were estimated to be less: £26,642 for thrice weekly HD as home self-care, £30,235 for standard in-center HD; and £29,866 for 5x/weekly HD as home self-care.

Read the abstract » | (added 2022-01-14)

Tags: Quanta SC+, Hemodialysis Costs

Can Urgent PD Starts Use Incremental PD?

In a retrospective study of 169 people who began PD, 111 started with incremental PD, while the remaining 58 began full-dose PD. Both groups were similar at the start. After 1 year, the full-dose group was on a higher PD prescription and had significantly higher PD adequacy numbers. Residual kidney function, blood pressure, anemia, and bone mineral correction were similar in both groups.

Read the abstract » | (added 2022-01-14)

Tags: Incremental PD, Full dose PD, PD Prescription, PD Adequacy, Urgent start Peritoneal Dialysis, Residual Kidney Function

Oral Hygiene and Nutritional Status on PD

Clean teeth mattered for nutritional status and hand grip strength in a small study (n=41) of people on PD. Inflamed gums can cause tooth loss and limit what people can eat. Those with dirty to very dirty teeth had poorer nutrition than those with clean or slightly dirty teeth, and their hand grips were weaker. Those with dirty teeth also had more GI symptoms and a higher risk of malnutrition.

Read the abstract » | (added 2021-12-16)

Tags: PD, Tooth Loss, Malnutrition, Gingivitis, Periodontitis