Journal Watch
Starting with PD Better than Switching to it from HD
A metaanalysis comparing patients who started with PD to those who began HD and then switched to PD after 3 months found significantly better overall and technique survival in the PD first group. There were no significant differences in the peritonitis rate.
Read the abstract » | (added 2020-07-10)
Tags: Hemodialysis, Peritoneal Dialysis, Renal Replacement Therapy
PD Probiotics, Malnutrition, and Health-related Quality of Life
In a controlled trial that randomized 116 PD patients into a probiotic and a control group, 2 months of probiotics reduced inflammation markers (HS-CRP and IL-6), and significantly improved serum albumin, upper arm circumference, and triceps skinfold thickness. The probiotic group also had higher physical and social functioning scores.
Read the abstract » | (added 2020-07-10)
Tags: Biochemical, Physical Functioning, Probiotic Supplementation
10-year PD Survival
In a group of 533 incident PD patients (mean starting age of 48 +16 years) followed from 2006 until 2018, survival at 1 year was 93%, at 3 years 81%, at 5 years 64%, and at 10 years 36%. Encapsulating peritoneal sclerosis (EPS) occurred in 1.3%.
Read the abstract » | (added 2020-06-10)
Does Extended Hour HD Helps Survival After Returning to Standard HD?
In an analysis of data from the ACTIVE Dialysis Trial, 200 standard HD patients were randomly assigned to 12 or 24 hours of treatment per week for a year, with follow up at 24, 36, and 60 months after a return to 12 hours of treatment per week. Long-term survival was not improved.
Read the abstract » | (added 2020-06-10)
Tags: Mortality, End Stage Kidney Disease, Hemodialysis, Randomized Controlled Trial
Soy Isoflavones Reduce Heart Disease Risk Factors in PD
A trial randomly assigned 40 PD patients to a soy isoflavone or placebo group, and took several measures of inflammation at baseline and 8 weeks. At the end of the study, those in the soy group had significant decreases in serum VCAM-1 and serum ICAM-1, two cardiovascular disease risk factors in PD patients
Read the abstract » | (added 2020-06-10)
Safety of Bedside PD Catheter Placement During COVID-19
Urgent-start PD is being used to address acute kidney injury due to COVID-19. A New York hospital successfully placed 14 PD catheters bedside to minimize use of critical hospital resources. The catheter did not work in one patient, who required HD. Another had bleeding stopped with compression and withholding of anticoagulants. The remaining 12 worked at follow up (3-18 days), with long-term follow-up suggested.
Read the abstract » | (added 2020-06-10)
Blood Vessel Damage Key to Encapsulating Peritoneal Sclerosis (EPS)
A study evaluated tissue samples from 174 PD patients with EDS and had used either conventional or neutral pH, low glucose degradation product PD solution. The conventional PD solution group had less angiogenesis but more severe blood vessel damage (P <0.001) and a higher rate of EPS relapse. Blood vessel damage was milder in the neutral pH group.
Read the abstract » | (added 2020-06-10)
Physical Activity and Survival in PD
Among 79 PD patients, fat and muscle mass, strength, and physical performance were not different between patients who were alive 2 years later and those who were not. However, the odds of death were 7.4 times higher in those whose level of physical activity was below the group’s median.
Read the abstract » | (added 2020-05-12)
Bioimpedance-measured Fluid Overload and Short Daily HD Survival
In 297 patients switched from thrice-weekly to 5-6 sessions per week of in-center short daily HD (SDHD), predialysis hydration was measured at initiation of SDHD and 6 and 18 months later using bioimpedance. Compared to patients whose predialysis fluid overload (FO) was <15% of extracellular volume (ECV), those whose FO was >15% of ECV had no survival difference by 6 months. However, at 18 months, those with an FO <15% had 91% survival, while those whose FO was >15% had just 72% survival (p = 0.0006), and remained significant after adjustment for demographic, clinical, and laboratory variables.
Read the abstract » | (added 2020-05-12)
Tags: Bioimpedance; Dialysis; Fluid Overload, Hd, Demographic
PD Catheter Placement Outcomes: Urgent- vs. Elective-start
After analyzing 13 years of data comparing urgent-start (n=29) and elective-start (n=211) PD, the only significant difference between the mostly-comparable groups was a higher incidence of catheter leaks. Complication and catheter removal rates at 3 and 12 months were similar, as were days to first complication and 12-month patient survival. Catheter placement technique did not affect the outcomes.
Read the abstract » | (added 2020-05-12)