Journal Watch
Outcomes in Urgent- vs. Early-Start PD
A study defining urgent-start PD (US-PD) as within 72 hours of catheter placement and early start (ES-PD) as 3 and 14 days later compared 72 patients in both groups. Both groups were comparable re: demographics, 30-day complications, 6-month hospitalizations, and PD dropout. US-PD patients were more prone to leakage.
Read the abstract » | (added 2020-07-10)
Tags: Peritoneal Dialysis, Disease Patients, Clinical Characteristics
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
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)
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)
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)
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)
Universal AVF Back-up for PD Patients Reduces HD Catheter Use
Should an arteriovenous fistula always be placed as a PD back-up for new patients? A retrospective study of two hospitals examined this question. Hospital RAH (n=142) did universal AVF back-up at PD start. Hospital PAH (n=232) did selective AVF back-up for “high risk” patients only. Yet, the transfer-to-HD rate at RAH was about half that of RAH (23% vs. 43%)—as was the HD catheter usage rate (33% vs. 65%; p<0.001), despite a population at RAH that was more likely to be older, Caucasian, and have diabetes.
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
Are PD eHealth Initiatives Ready for Prime Time?
A review of 15 studies (n=1,334) of use of telemedicine and eHealth to support PD self-management found bias and low-quality evidence that made a metaanalysis impossible. While no adverse effects of eHealth interventions were reported, effectiveness was mixed. Better quality evidence is needed.
Read the abstract » | (added 2020-05-12)
Tags: Digital Health, EHealth, Peritoneal Dialysis, Evidence
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)