Journal Watch
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Impact of a 1-hour Discussion on Choice of a Home Dialysis Option
Of 620 incident dialysis patients in Japan from 2013 to 2021, 128 received a 1-hour discussion of treatment options. The discussion group had a tendency for fewer urgent hospitalizations—and had a significantly higher chance of choosing PD (30.7% vs. 9.4%).
Read the abstract » | (added 2022-11-16)
Tags: Patient Education, Dialysis Modality, Treatment Options
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Which Modality is Better Between Transplants: PD or HD?
Among 776 people in a registry who received a second kidney transplant, 656 did standard in-center hemodialysis (HD) between transplants, 72 did PD, and 48 went immediately to a second transplant. Those who did PD or went directly to a second transplant had better adjusted survival than those on HD.
Read the abstract » | (added 2022-11-16)
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Remote vs. In-person PD Training: Which is Better?
It’s a tie, finds a small, retrospective Italian study comparing 21 in-home, in-person PD trainings from 2014 through 2016 to 25 video-based training from 2016 through 2018. After a home visit, PD training done by telemedicine. Actually, there were 5 episodes of peritonitis in the home training group—and 0 in the telemedicine group. And, 2-year technique survival with in-person training was 56.3%—while for telemedicine training, it was 76.9%.
Read the abstract » | (added 2022-10-17)
Tags: Remote Training, PD Training, Telemedicine
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Savings from Incremental PD
In a stud of 147 people who did incremental PD from 2009 through 2021, 11.9% transitioned to full-dose PD. Peritoneal glucose exposure was reduced by multiple kilos per year, and costs, plastic waste, and water use were also lower, as was time to manage PD.
Read the abstract » | (added 2022-10-17)
Tags: Healthcare Cost, Cost Analysis, Incremental PD, Full dose PD, Peritoneal Glucose Exposure
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PD: Sweat it Out to Reduce Fluid Overload
In a small study, 4 people on PD used a portable sauna bath daily for 10 days, at 30 minutes a day and a temperature of 45°C. Most (51) of the 54 sauna sessions were well-tolerated; two people reported dizziness and one person with advanced diabetic neuropathy received a second degree skin burn. Body water loss and blood pressure improved significantly from the control period. Larger studies are needed.
Read the abstract » | (added 2022-10-17)
Tags: Diaphoresis, Fluid Overload, Sauna Bath, Sweat
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Better COVID Survival with PD and Home HD
Among 1,336 people whose kidneys failed between March, 2020 and January, 2021, 13.12% (n=178) contracted COVID-19. Of these, most (n=139) did standard in-center HD, and 33 (3.87%) died. On PD, 39 people developed COVID, and 1 (0.81%) died. On home HD, there were zero cases of COVID and no deaths. Five transplant patients developed COVID, with a mortality rate of 1.47%.
Read the abstract » | (added 2022-10-17)
Tags: Covid, Standard In center HD, PD, Mortality, Home HD, Home Hd And Covid, Transplant
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The Varied Uses of Assisted PD in Spain
In a retrospective look from 1997 through 2020, a Spanish clinic identified four groups who used assisted PD at some point. Group 1 was totally dependent at PD start, group 2 was self-care and then became totally dependent, group 3 needed short-term PD help, and group 4, the controls, remained on self-care. Of those who required assistance, 73% did so during follow up, not initially. Up to 44% of autonomous patients became dependent for various reasons over time, including loss of a care partner. Assisted PD—even when paying care partners—was less costly than switching to standard HD.
Read the abstract » | (added 2022-10-17)
Tags: Assisted PD, Dependency
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Impact of Telemedicine on PD Technique Survival
Can telemedicine (TM) help people stay on PD longer? A prospective study conducted in 27 hospitals in China since 2016 enrolled 7,539 patients. Compared to matched patients in the non-TM group (60.9%), those in the TM group (39.1%) had significantly lower risks of severe fluid overload, inadequate solute clearance, non-infectious catheter complications, transfer to HD, and death.
Read the abstract » | (added 2022-09-13)
Tags: Telemedicine, PD, Technique Survival, Fluid Overload, Inadequate Solute Clearance, Non infectious Catheter Complications
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HD Dose and Patient Survival: More is Better
Even using spKt/V—a flawed measure that considers only urea—a study of 558 standard HD patients from 2015 to 2020, of whom 214 died, found that a higher dose of dialysis reduced the risk of all-cause mortality by 33%.
Read the abstract » | (added 2022-09-13)
Tags: HD Dose, Dialysis Dose, Patient Survival, All cause Mortality
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Safety of Exercise for Those Who Do PD
A review of 25 studies of exercise in PD found only minor adverse events, mainly short-term muscle or joint pain or fatigue. There were no serious adverse events or signs of harm.
Read the abstract » | (added 2022-09-13)
Tags: PD, Peritoneal Dialysis, Exercise, Benefits, Adverse Events