Journal Watch
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Advantages of PD in Primary Glomerulonephritis (PGN)
A prospective observational study followed all incident PD patients (n=2,243) who had PGN in the Levante registry from 1995 to 2014. Compared to other diagnoses, those with PGN had a significantly lower rate of peritonitis and better mean survival. The authors conclude that “PD has several advantages as a first dialytic treatment, and our results suggest that it is an excellent technique to manage patients with PGN while they await a kidney transplant.”
Read the abstract » | (added 2020-09-11)
Tags: Patient Survival, Peritoneal Dialysis, Primary Glomerulonephritis
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Impact of Depression on PD Patient and Technique Survival
Among 275 patients who had done CAPD for at least 3 months, 31.3% tested as having depressive symptoms. Long-term patient and technique survival were significantly poorer in this group, even adjusting for cofounders.
Read the abstract » | (added 2020-09-11)
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PD vs. Standard HD for Cognitive Function
A metaanalysis of papers including 195,774 patients looked at whether PD or standard in-center HD better supported cognitive function. The authors found significantly less risk of cognitive impairment among those who did PD.
Read the abstract » | (added 2020-09-11)
Tags: Cognitive, Renal Failure
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PD and Bone Mineral Disorders vs. HD
Body composition, nutritional status, DEXA, and bone mineral disease (BMD) biomarkers were assessed at baseline and one year in 242 ESRD patients starting either PD (n=138) or HD (n=104). Among HD patients, BMD decreased significantly—but not in PD patients. Preservation of BMD was associated with significantly lower all-cause mortality, with cortical bone preservation more predictive than trabecular bone preservation.
Read the abstract » | (added 2020-09-11)
Tags: End stage Renal Disease, Bone Mineral Density, Dialysis
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Benefits of PD Remote Monitoring
A retrospective study compared two groups of APD patients, one that received remote monitoring (n=38) and one that received routine care (n=35). PD dropout and fluid status were similar between the two groups. But, the remote monitoring group had fewer ER and hospital visits related to kidney disease, especially among those with more comorbidities. Patients also preferred remote monitoring, and were more satisified with their care.
Read the abstract » | (added 2020-09-11)
Tags: Clinical Outcomes, Quality Of Life, Remote Monitoring, Telemedicine
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International Use of PD
Worldwide PD use is approximately 11%, which varies across the globe, finds a new survey of stakeholders in 182 countries (with 313 respondents from 160 countries). Median PD use was 38.1 per million. Thirty countries, mainly low-income, did not offer PD, while in 69% of countries, PD was the first modality for <10% of incident patients. The range of PD costs passed on to patients was 1-25%, with higher co-pays in South Asia and low-income countries. Patient-reported PD outcomes were rarely measured.
Read the abstract » | (added 2020-09-11)
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SARS-CoV-2 in PD Effluent
Analysis of bodily fluids from 3 SARS-CoV-2-infected PD patients found that, while viral load was quite high in nasopharyngeal swabs, none of the PD effluent tested positive, even after dialysate concentration. This suggests that the risk of virus transmission from used PD fluid may be low.
Read the abstract » | (added 2020-09-11)
Tags: COVID 19, SARS CoV 2, Peritoneal Dialysis
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International Use of HD—Including Home HD
A new survey of stakeholders in 182 countries (with respondents from 160 countries) found a use rate for HD of 298.4 per million. Among incident dialysis patients, the HD rate was 98.0. Standard in-center HD was available among 27% of low-income countries (and these patients paid more of the costs); home HD was available in 36% of high-income countries. Monitoring of patient-reported outcomes was done in 61% of countries, while 60% monitored bone minerals and patient survival, and 51% monitored technique survival. Just 5% of countries initiated patients on HD with arteriovenous access.
Read the abstract » | (added 2020-09-11)
Tags: Hemodialysis, Homedialysis, HD
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Case Report: Intensive Daily HD Improves Lung Function
After initiating 32 hours of intensive home HD per week, a patient with restrictive lung disease had improvement in both clinical and spirometric lung function.
Read the abstract » | (added 2020-08-11)
Tags: Home Hemodialysis, Intensive Hemodialysis, Restrictive Lung Disorder
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Home HD Respite Care Resource Implications
A Canadian analysis of 119 home HD patients found that 66% required 292 back-up, in-center HD sessions during 96 patient years; 53% for vascular access issues.
Read the abstract » | (added 2020-08-11)
Tags: Home Hemodialysis, Resource Utilization, Technique Survival