Journal Watch
Urgent Start PD: Better Survival, Fewer Complications than Urgent Start HD
A metaanalysis pooling data from seven studies found that urgent start PD was linked with significantly better survival than urgent start HD, though infectious complications were comparable. Urgent start PD had significantly less risk of mechanical complications as well.
Read the abstract » | (added 2021-09-14)
Tags: Urgent start Peritoneal Dialysis, Survival, Urgent Start HD, Mechanical Complications, Infectious Complications
A Home First Policy Helps Drive Home Therapy Choice
In the multinational Peridialysis study, of 1,587 people starting dialysis, 32.5% were judged “unsuitable” for a home treatment due to contraindications—or a lack of assessment. Among the suitable 1,071, 65.4% chose PD and 3.6% chose home HD, and the remainder went in-center. Late referral, suboptimal dialysis initiation, acute illness—and no “home dialysis first” policy were factors linked to use of in-center HD.
Read the abstract » | (added 2021-09-14)
Tags: Lack Of Assessment, Glomerular Filtration Rate, Haemodialysis, Peritoneal Dialysis, Pre dialysis, Uraemia
NxStage Outcomes in Spain
The first 86 NxStage users in 12 Spanish dialysis clinics received an adequate dialysis dose, optimal ultrafiltration, improved biochemical markers, and reduced need for antihypertensive drugs, binders, and erythropoietin. Patient and technique survival were both good.
Read the abstract » | (added 2021-09-14)
Tags: Adequate Dialysis Dose, Optimal Ultrafiltration, Biochemical Markers, Antihypertensive Drugs, Binders, Erythropoietin. Patient Survival, Technique Survival
Poorer Survival for Those Who Switch from Home to In-center HD
Among 19,306 people who started HD in the ANZDATA registry from 2005 to 2015 and were treated for more than 90 days, those who started home HD and then went to in-center HD had significantly higher mortality than those who stayed at home. The reasons for this are not yet known.
Read the abstract » | (added 2021-08-12)
Tags: HD, Home HD, In center HD, Mortality, Home Hemodialysis Treatment Failure
Encapsulating Peritoneal Sclerosis Linked to Vasculopathy
EPS is a rare but devastating complication of PD. Tissue samples from 223 people with EPS who had surgery to remove adhesions were analyzed under a microscope. In the 174 samples that could be evaluated, the individuals who had used conventional PD fluid had more severe vasculopathy and longer PD durations than those who used pH neutral PD fluid.
Read the abstract » | (added 2021-08-12)
Healthcare System Change Increased PD and Home HD in Australia
A lean-thinking framework and commitment of top leadership to change the system of care were used in a “Home before Hospital” approach to increase use of home therapies. Multidisciplinary Pathway, Outreach, and Hybrid working groups were established, and goals were set. A target of >30% for PD and home HD was achieved in 2 years, 35% within 3 years—and was still being maintained at 8 years.
Read the abstract » | (added 2021-08-12)
Tags: Peritoneal Dialysis, PD, Home Haemodialysis
Outcomes of Incremental PD
A retrospective cohort study looked at 175 PD patients followed for about 2 years. Starting PD with a lower vs. higher dose was associated with better survival.
Read the abstract » | (added 2021-08-12)
Tags: Peritoneal Dialysis , PD, End stage Kidney Disease, Dialysate Volume, Survival
Feel Low on PD? Could be Vitamin D
In a study of 50 people on PD, those with vitamin D deficiency (< 20ng/mL) did more poorly than those with adequate vitamin D levels on all subscales of the KDQOL-36 survey to measure health-related quality of life. High blood pressure was also a factor in higher kidney disease burden.
Read the abstract » | (added 2021-08-12)
Tags: Serum Vitamin D Levels, Health related Quality Of Life, Peritoneal Dialysis
Higher HD Dose Linked with Better Survival
A national registry of 32,283 standard HD patients found that “a higher dose of dialysis was consistently associated with better survival.” Kt was most discriminating, with survival highest in the upper Kt quartile. Arteriovenous access, hemodiafiltration, scheduled dialysis initiation, and long weekly HD hours predicted higher Kt.
Read the abstract » | (added 2021-07-12)
Tags: Dialysis Frequency, Survival, Kt, Mortality
The Clinical Experience of In-center Nocturnal HD
An analysis of 4 years of INHD looked at 12 patients who chose to stop, 24 patients who continued, and interviews with patients and staff. A “starter pack” given to aid sleep in new INHD patients was well-received and sleep was not a reason to stop INHD. Staff were most concerned about emergency support, though staffing ratios were the same as during the day. Most of the clinical incidents for INHD centered around communication with patients and families, patient transfer delays, and equipment issues—not medical interventions, infection control, and transport, as during the day. Those who continued with INHD felt they had more social time and perceived health benefits.
Read the abstract » | (added 2021-07-12)
Tags: INHD