Journal Watch
European Patients Live Longer with Extended HD Treatments
Compared to standard in-center HD, patients from eight European countries who dialyzed for 6+ hours thrice weekly lived longer. Of 142,460 patients, 1,338 did extended HD. Compared to in-center HD (13.5/100 person-years), crude mortality for extended HD (6.0/100 person-years) was significantly better. Overall, those treated with extended treatments were 73% more likely to have survived.
Read the abstract » | (added 2019-12-10)
Tags: Survival, Extended hours Hemodialysis, Haemodialysis, ERA EDTA Registry
In-center Nocturnal HD: Fewer Complications than PD in Patients with PKD
An analysis that matched PDK patients who did conventional HD (26) or PD (26) to in-center nocturnal HD (NHD; 13) found no significant difference in mortality—but after a median follow up of 5.5 years, NHD had significantly fewer complications than PD—and higher serum albumin levels as well.
Read the abstract » | (added 2019-12-10)
Tags: Polycystic Kidney Disease, Conventional Dialysis, In center Nocturnal HD, Nocturnal Hemodialysis, Mortality
PD—Controlling Volume to Reach Normal Hydration Protects the Heart
Reanalysis of data from a multicenter, prospective, randomized controlled trial looked at fluid control in PD in 151 patients followed for a year. While most (120) reached normal hydration levels as measured by bioimpedance analysis, those who did not had significantly higher left atrial diameter—and a lower left ventricular ejection fraction at the end of the study.
Read the abstract » | (added 2019-12-10)
Tags: Fluid Management, Cardiovascular Risk, PD, Peritoneal Dialysis, Bioimpedance Spectroscopy
Higher Serum Phosphorus Predicts More Residual Function Loss—in Men Only
A retrospective analysis of 1,245 CAPD patients followed for up to 11 years divided participants into tertiles based on their baseline serum phosphorus levels. One third of patients lost residual renal function (RRF) during the study, and those with the highest baseline phosphorus levels had a 51% higher risk of RRF loss than those in tertiles 1 and 2 combined. The risk of RRF loss was significantly higher for men.
Read the abstract » | (added 2019-12-10)
Tags: Serum Phosphorus, Renal Function Loss, Gender, Peritoneal Dialysis
Is PD Unwise for Patients with Lupus Nephritis?
A small study found 92.4% (1 year), 84.7% (3 year) and 67.6% (5 year) patient survival among 28 non-diabetic lupus patients doing PD—compared to 100% (1 year), 93.5% (3 year), and 82.9% (5 year) among 56 controls. While the lupus was not directly associated with mortality, it was a risk factor for PD technique failure, infection, and hospitalizations.
Read the abstract » | (added 2019-11-16)
Tags: Patient Survival, Lupus, PD, Mortality, Technique Failure, Infection, Hospitalization
Home Dialysis “Virtual Ward” Addresses Gaps in Care Transitions
Following hospital discharge, a procedure, antibiotics, or completion of home training, 2 weeks of telephonic follow-up was provided to 193 PD or home HD patients as a “home dialysis virtual ward” (HDVW). The HDVW identified a median of 1 care gap per patient, with newer patients at higher risk of gaps. Patients were highly satisfied with the HDVW.
Read the abstract » | (added 2019-11-16)
Tags: Home Dialysis, Home Dialysis Virtual Ward, HDVW, Care Gap
Antibiotics Before Colonoscopy May Reduce Peritonitis Risk in PD Patients
In a retrospective study of 236 CAPD patients who had colonoscopies, 9 developed peritonitis within a week of the procedure. No patient who received prophylactic antibiotics developed peritonitis. Randomized controlled trials are recommended.
Read the abstract » | (added 2019-11-16)
Tags: CAPD, Colonoscopy, Peritonitis, Prophylactic Antibiotics, Polypectomy, Endoscopic Mucosal Resection
PD vs. Standard In-center HD for Quality of Life
A 24-month observational study compared 45 standard HD and 30 PD patients, and assessed their quality of life, cognitive function, and depression at study start and every 12 months. Over the 24 months, PD patients had significant improvement in physical and social well-being—while HD patients stayed the same. Cognitive function held steady in PD patients—but declined in HD patients. Depression increased among those on standard HD—but not those on PD.
Read the abstract » | (added 2019-11-16)
Tags: Peritoneal Dialysis, Hemodialysis, Cognitive Function, Emotional Distress, Quality Of Life
Tablo HD Machine Safe and Effective at Home and In-center
Safety and efficacy human trials of the easy-to-use Tablo were conducted with 28 participants who received 4 treatments per week in-center and then at home for a total of 21 weeks. Home adherence (99%) was slightly better than in-center (96%), with average prescribed—and delivered—treatments of 3.4 hours, and an average weekly standard Kt/Vurea of 2.8 in both settings. Adverse events were not related to the Tablo, and alarm resolution time was 8 seconds in-center and 5 seconds at home.
Read the abstract » | (added 2019-11-16)
A Post-op Surgical Girdle for Pain and Catheter Tunnel Infections in Urgent Start PD
Urgent start PD can be associated with pain and tunnel infections. In a study of 85 consecutive PD catheter placements, a surgical girdle was used from days 1-3 while patients were supine. Among the 23 patients who completed pain surveys, the girdle helped significantly. Tunnel infections were reduced as well.
Read the abstract » | (added 2019-11-16)
Tags: Urgent Start PD, Pain, Tunnel Infection, PD Catheter, Surgical Girdle