Journal Watch
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Prospective Cohort Study of Urgent-start APD
Can automated PD be used for urgent-start dialysis? A study from China enrolled 68 people who needed to start treatment urgently and did either APD (52.9%) or HD. After following for an average of 20.1 months, the APD group had “significantly fewer short-term dialysis-related complications,” and lower hospital costs. Both groups had similar technique survival, infection rates, and patient survival.
Read the abstract » | (added 2022-07-13)
Tags: Automated Peritoneal Dialysis, Cost effectiveness, End stage Renal Disease, Esrd, Urgent start
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Rapid Differentiation of PD Peritonitis Causes
Eosinophilic vs. microbial peritonitis requires different treatment, but cultures take days—and still may not find the cause. A center used effluent microscopy—slides of gram-stained PD fluid under a microscope—to determine if microbes were present and if so, which types. Among 250 people between 2007 and 2017, there were 155 at-risk cases of peritonitis, hemacolor staining was key to differentiating the cause and guiding treatment.
Read the abstract » | (added 2022-07-13)
Tags: Eosinophilic, Microbial, Peritonitis, Effluent Microscopy, Hemacolor Staining
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Safety and Efficacy of Wearable PD
The automated wearable artificial kidney (AWAK) uses sorbent technology. In a pilot study done in Singapore, patients used the AWAK for 72 hours and were followed up for a month. Among the 15 patients who took part, the AWAK had to be altered to fix blocked flows, but no serious adverse events occurred. Abdominal pain (60%) and bloating (47%) were reported.
Read the abstract » | (added 2022-07-13)
Tags: Peritoneal Dialysis, Automated Wearable Artificial Kidney, AWAK, Sorbent Technology
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In Which Countries Do People Stay on PD Longer?
The Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) analyzed time on PD among 218 randomly chosen clinics and 7,121 patients in seven countries including the U.S. Median time on PD ranged from 1.7 years in the UK to 3.2 years in Japan and Thailand. PD mortality risk was higher in Thailand and the U.S., and infection was the leading cause of transfers to HD.
Read the abstract » | (added 2022-06-10)
Tags: Peritoneal Dialysis Outcomes And Practice Patterns Study, PDOPPS, PD, Mortality, Hemodialysis Transfer, Kidney Transplantation
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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
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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)
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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)
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Home HD Patients Grasp Fluid Management Better than In-Center Ones
Compared to 839 people on in-center HD in the UK from six clinics, 99 receiving home HD had significantly more knowledge about fluid management and signs and symptoms of fluid overload. They also felt more in control and reported better adherence—though knowledge gaps remained.
Read the abstract » | (added 2022-06-10)
Tags: In center HD, Home HD, Fluid Management, Fluid Overload, Ckd Education
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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
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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