Journal Watch
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Shared decision-making (SDM) About Modality: PD vs. HD Experiences
A cross-sectional survey of 300 dialysis patients (82 on PD and 218 on HD) revealed that those on PD were significantly more likely to report having received an SDM conversation than those on HD. The authors conclude that SDM should take place in the early stages of CKD.
Read the abstract » | (added 2021-03-09)
Tags: Hemodialysis, Peritoneal Dialysis, PD
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Outcomes and Costs of Assisted PD
As many as half of those who could use PD need assistance to do so, and many countries outside the U.S. offer this. A narrative review found no differences in quality of life, hospitalization, or mortality between PD and in-center HD patients after adjusting for age and frailty. Nurse assistance may result in better technique survival than family assistance. Assisted PD was still significantly less costly than in-center HD in Canada and Western Europe.
Read the abstract » | (added 2021-03-09)
Tags: Assisted Peritoneal Dialysis, Barriers, Cost, Hemodialysis, Peritoneal Dialysis, Pd
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Virtual Nephrologist Mentoring for Home Therapies
A “hub and spoke” model for virtual home mentorship may help overcome some of the physician barriers to home therapies, suggest some of the top Canadian home dialysis nephrologists, who also review the literature.
Read the abstract » | (added 2021-03-09)
Tags: Home Dialysis, Peritoneal Dialysis, Pd
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New PD Fluid Tested in Italy
Most PD fluid is glucose-based, unphysiologic, and can cause fibrosis and long-term damage to the peritoneum—but that may be changing. A new PD fluid replaces the glucose with L-carnitine and/or xylitol. After 4 weeks on the new fluid, 10 CAPD patients had good tolerance and no adverse safety events. More research will be needed, but this looks promising.
Read the abstract » | (added 2021-03-09)
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Choosing Home Dialysis Does Not Mean Getting It
A retrospective, single-center study that followed 167 patients referred for CKD education in 2019 through 2020 found that just 23% chose standard in-center HD—74% chose home, and the remaining 3% were undecided. But, with 90% of patients living in New York City with limited space, and a clinic requirement that a trained care partner be present for all treatments, 56% of the in-center HD patients had chosen a home treatment. (Hint: Stop requiring a care partner!)
Read the abstract » | (added 2021-02-09)
Tags: Home Dialysis, Home Hemodialysis, Peritoneal Dialysis, Pd
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A Better Nutritional Marker for CAPD Adequacy
Move over prealbumin, albumin, and ferritin—normalized protein catabolic rate (nPCR) was the only marker that correlated with CAPD adequacy in a study of 266 patients divided into an adequate (total weekly Kt/V urea >1.70) and an inadequate PD group (<1.70). Male gender, higher weight, and residual GFR <2.43 mL/min/1.73m2 were risk factors for inadequate CAPD.
Read the abstract » | (added 2021-02-09)
Tags: Peritoneal Dialysis, Pd
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The Better to See You With, My Dear
Would you rather have a surgeon feel where a PD catheter should go—or see what s/he is doing? Researchers tried an optical puncture system on 25 patients between 2018 and 2019, while 40 patients had routine placements. Even though more of the optical patients had prior abdominal surgeries, catheter placement took less time and had a similar rate of complications.
Read the abstract » | (added 2021-02-09)
Tags: Peritoneal Dialysis, Catheter, Optical Puncture System
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Low PTH Levels a Risk Factor for Peritonitis on PD
Two hundred seventy incident PD patients over a 7-year period were divided into a low-PTH (<150 pg/mL), middle-PTH (150-300 pg/mL), and high-PTH (>300 pg/mL) groups. After follow up for 16-49 months, patients with low PTH levels had a 64% higher risk of peritonitis.
Read the abstract » | (added 2021-02-09)
Tags: Peritoneal Dialysis, Pd, Parathyroid Hormone
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Remote Monitoring May Reduce PD Technique Failure
In a study looking back at 558 adult APD patients, 148 who had used remote monitoring were matched to 148 patients from the 410 who had not. The researchers found a significantly lower rate of PD technique failure in the remote-monitored group. More studies are needed.
Read the abstract » | (added 2021-01-12)
Tags: Technique Failure, Telemedicine.
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Mobile Health Readiness of Home vs. In-Center Dialysis Patients
Smartphones and other mobile devices can be used to deliver health messages. In a survey of 949 patients from 14 home and 21 in-center dialysis clinics, 81% had mobile devices to get online, and 72% used the Internet, some (18%) despite concerns about data privacy and security. Younger, non-Hispanic, and more educated patients were more likely to use mobile health, and working patients had the highest rates of proficiency. After adjustment, in-center and home patients were equally proficient with mobile health.
Read the abstract » | (added 2021-01-12)
Tags: Kidney Disease, Hemodialysis, Telehealth, Telemedicine