Journal Watch
Impact of a Nurse-led Protocol on PD Fluid Overload
Among PD patients divided into a group symptomatic of fluid overload (>2L; n=53) and a group that was not (n=50), a 12-week nurse-led education and motivation intervention—with hypertonic cycles for short-term relief of fluid overload—significantly reduced overhydration. Knowledge and adherence were both significantly improved as well.
Read the abstract » | (added 2020-01-09)
PD vs. In-center HD for Sudden Cardiac Death
A Korean registry study of 132,083 PD and in-center HD patients followed between 1985 and 2017 analyzed 34,532 deaths. Sudden cardiac death (SCD) was responsible for 19.6% of deaths on PD and 22.2% of deaths on in-center HD. Even after adjusting for age and comorbidities, the risk of SCD was higher with HD.
Read the abstract » | (added 2020-01-09)
Tags: PD, In center HD, Sudden Cardiac Death
A Novel Surgical Technique for Urgent Start PD
Placing a PD catheter with a double purse-string around the inner cuff was safe and feasible for urgent start PD, finds a study of 135 catheter insertions between 2011 and 2018. Double-cuffed straight Tenckhoff catheters were implanted surgically or semi-surgically using the double purse-string technique, and the incidence of leakages, dislocations, peritonitis, and exit-site infection were low. There were no bleeding events, bowel perforations, or hernia formations.
Read the abstract » | (added 2020-01-09)
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
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
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
Simultaneous Hernia Repair and PD Catheter Placement
Taking care of two surgeries at once saves a procedure, recovery time, and costs. Among 123 patients who had catheters placed at a single center over a 4-year period, 23 (19%) had hernias. Across the 23, 27 procedures were done combining hernia repair with PD catheter placement. None of the hernias recurred, and there were no early surgical site infections. Five of the patients developed new hernias at other sites, but after a median of about 3 years, 96% of the catheters were still working.
Read the abstract » | (added 2019-12-10)
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
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