Journal Watch
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Impact of Assisted PD
A retrospective look at 1,576 incident patients at one clinic between 2002 and 2017 examined the effects of offering assisted PD on the rates and cumulative incidence of PD starts. Those who used assisted PD tended to be older. Use of the program significantly increased the rate of PD initiation, but there was a fall in usage over time.
Read the abstract » | (added 2020-04-13)
Tags: Renal Replacement Therapy, Assisted Peritoneal Dialysis
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Cardiovascular Benefits of Benefits
A review considers the impact of nocturnal HD on cardiac remodeling, myocardial stunning, hypertension, heart rate variability, sleep apnea, coronary calcification, and endothelial dysfunction.
Read the abstract » | (added 2020-04-13)
Tags: Benefits, Cardiovascular, Home Hemodialysis, Myocardial Stunning, Nocturnal Hemodialysis, Vascular Calcification, Cardiovascular Disease
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Nocturnal HD in Children
There are very few studies of the impact of intensified hemodialysis regimens (days/hours) on children. This review addresses implementation challenges.
Read the abstract » | (added 2020-03-16)
Tags: Intensified Hemodialysis, Children, Implementation Challenges
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Glucose Degradation Product (GDP) Disrupts Peritoneal Membrane Function
Growth of new, immature blood vessels on the peritoneal membrane is linked with ultrafiltration failure. Exposure to the GDP methylgyoxal (MGO) up-regulated both vascular endothelial growth factor (VEGF) and suppressed platelet-derived growth factor (PDGF) in vitro, potentially disrupting the balance of angiogenesis.
Read the abstract » | (added 2020-03-16)
Tags: Peritoneal Membrane, Ultrafiltration Failure, Methylgyoxal, Angiogenesis
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Physician Reimbursement Increases Did Not Drive PD in Canada
Among a cohort of 4,262 patients in Alberta, Canada followed between 2001 and 2014, an increase in PD physician pay from $0 to $135 (over a 9-year period) revealed no statistical evidence of a difference in PD use or trends—and the role of the physician in modality selection was unclear.
Read the abstract » | (added 2020-03-16)
Tags: PD Physician Pay, PD Use Trend
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Peritonitis with Diarrhea Could be C-diff
Cloudy PD dialysate can signal infectious peritonitis from a variety of causes—including C-diff. But, use of cephalosporins could worsen a C-diff infection. A new article presents two case histories of C-diff peritonitis and suggests reexamining the traditional empiric treatment of peritonitis when diarrhea is present.
Read the abstract » | (added 2020-03-16)
Tags: PD Dialysate, Infectious Peritonitis, C diff, Cephalosporins, Empiric Treatment, Diarrhea
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Glucose and Peritonitis
A prospective, longitudinal cohort study followed 105 PD patients for up to 5 years (mean of 23 months). Higher glucose exposure significantly predicted peritonitis, and patients with more residual kidney function also had a significantly longer time to first bout of peritonitis. Read the abstract. The authors suggest using the lowest concentration of glucose possible.
Read the abstract » | (added 2020-03-16)
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Why Early Survival on PD Matters
If survival between PD and standard in-center HD “evens out in the end,” does it matter? Yes, argues Mark Marshall, MD, from New Zealand. The early survival benefit increases patient life years—and persists even when accounting for use of central venous HD catheters. To support shared decision-making, patients have the right to know about survival on PD vs. standard HD.
Read the abstract » | (added 2020-03-16)
Tags: Survival, PD, In center HD, Early Survival, HD Catheter
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Double Purse String Suture for Urgent Start PD Catheters
An Italian article reports that use of a double purse-string technique allowed immediate CAPD starts within 24 hours of catheter placement, with no difference in complications (mechanical or infectious) or catheter survival between surgical or trocar placement.
Read the abstract » | (added 2020-03-16)
Tags: Double Purse string, CAPD Starts, Catheter Placement, Catheter Survival
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Patient and Clinic Factors Driving Home Dialysis in Australia/New Zealand
Among 54,773 patients in 76 centers in the ANZDATA registry, an overall 45% (0-87%) were using some form of home dialysis. Males, people of color, and patients who were older, had comorbidities, experienced late nephrology referral, lived remotely, or were obese had lower uptake of home therapies. Smaller centers, those with shorter hours, and clinics who had fewer patients with permanent access had lower uptake as well.
Read the abstract » | (added 2020-02-19)