Journal Watch
Organizational Culture and Home Dialysis Uptake
An ethnographic study of dialysis clinic culture was conducted at four clinics in England with average or high rates of home dialysis and maximal geographic, ethnic, and socioeconomic diversity. Three themes identified were encouraging the patient voice and providing individualized support, ensuring home dialysis access (minimalizing eligibility assumptions), and achieving sustained change based on benefits for patients.
Read the abstract » | (added 2025-01-13)
Tags: Dialysis Clinic Culture, Home Dialysis Access, Patient Benefits
Probiotics in PD
While the gut microbiome can be key to challenges PD patients often face, there have been little specific data on the use of probiotics by PD patients. A review article summarizes current knowledge, explores how interventions could improve PD outcomes, outlines clinical effectiveness data, and suggests future research directions.
Read the abstract » | (added 2025-01-13)
Tags: Gut Microbiome, PD Outcomes, Probiotics
Advancing American Kidney Health Initiative Did Not Impact Public Awareness
In 2019, the AAKHI aimed to increase the use of home dialysis. Analysis of U.S. Google Trends data from 2013 to 2021 for home dialysis terms found an increase in searches when the AAKHI was first announced, followed by flat or declining searches. The authors concluded that the AAKHI did not impact public information-seeking and targeted education initiatives may be needed.
Read the abstract » | (added 2025-01-13)
Tags: Advancing American Kidney Health Initiative, AAKHI , Public Awareness
Predicting Sarcopenia on PD using Handgrip Strength and BMI
Identifying patients at risk of sarcopenia without costly assessment tools would allow for earlier treatment. Analysis of data from 699 PD patients in China found a sarcopenia prevalence of 13.92% and nomogram models identified handgrip strength and BMI as independent predictors.
Read the abstract » | (added 2025-01-13)
Tags: Body Mass Index, Handgrip Strength, Nomogram, Peritoneal Dialysis, Risk Factors, Sarcopenia
Impact of PD Exchange Volume/Day on Outcomes
A DOPPS cohort study in Japan divided patients into two groups by daily PD dialysate volume (<4L/day; n=98 or >4L/day; n=244). Despite demographic differences between the groups, there were no significant differences in transfers to HD, mortality, hospitalization, peritonitis, or patient-reported outcomes based on volume—thus less volume may be more cost effective.
Read the abstract » | (added 2024-12-11)
Tags: Dialysate Volume, Peritoneal Dialysis Outcomes, Mortality, Patient reported Outcomes
Long-term PD vs. HD on Left Ventricular Function
In a small echocardiogram study of long-term dialysis patients (mean of 125.1+35.2 months), 24 CAPD patients and 23 HD patients were assessed for LV function, LVH, and LV geometry. Left ventricle dysfunction, LVH, and deterioration in LV geometry were significantly worse in the PD group.
Read the abstract » | (added 2024-12-11)
Tags: Echocardiogram, LVH, Left Ventricular Hypertrophy, Left Ventricle Dysfunction, CAPD, HD
Do Ketoanalogue (KA) Supplements Preserve Residual Kidney Function in PD?
A 1-year, six center, randomized, double-blind trial investigated the impact of KA supplements on RKF in 153 CAPD patients vs. placebo. For patients with early PD initiation, the KA group had a significantly lower decline in RKF. No differences were found in RKF decline in those with late PD starts or in PD adequacy, peritoneal function, nutritional status, or quality of life scores between groups.
Read the abstract » | (added 2024-12-11)
Tags: KA Supplements, Residual Kidney Function, CAPD, Ketoanalogues
Early Icodextrin (ICO) Use Reduced PD-associated Peritonitis Risk
A group of 82 patients who did PD between 2011 and 2020 were divided into a group (n=21) who received ICO at PD initiation and a group (n=61) who received it later or not at all. Patients were followed until they stopped PD, died, or 3 years passed. PD-associated peritonitis and tunnel infection-free survival rates were significantly better with early ICO use.
Read the abstract » | (added 2024-12-11)
Tags: PD, ICO, Early Icodextrin, Peritonitis, Tunnel Infection free Survival Rates
Stepwise PD Starts vs. Conventional PD Starts—Which is Better?
Stepwise Initiation of PD (SIPD) is an approach that uses a gradual introduction to PD (perhaps like incremental PD in the U.S.?). In a retrospective look at 39 SIPD patients vs. 78 conventional PD (CPD) starts during a 13-year period matched for age and sex, early complications and PD catheter survival were similar between groups. But, late complications were significantly lower in the SIPD group. The authors believe SIPD may aid tissue healing and reduce biofilms, which may reduce infections. As always, more studies are needed…
Read the abstract » | (added 2024-11-21)
Tags: Stepwise Initiation Of PD, Incremental PD, Late Complications, Infection, Tissue Healing, Biofilms
Staying Infection-free with PD and Home HD
While home treatments tend to be better treatments, infection is still a risk—and prevention a necessity. Education and inclusion of infection-prevention in training are important, as are managing modifiable risk factors, such as constipation, gastric acid blockers, and hypokalemia in PD. For home HD, reducing CVC use and duration and using the rope ladder technique for cannulation can reduce risk.
Read the abstract » | (added 2024-11-21)
Tags: Infection prevention, Modifiable Risk Factors, PD, HHD, Central Venous Catheters, CVC