Journal Watch
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
Transplant Survival Better After PD Than Standard In-center HD
Is there an advantage to PD over standard in-center HD for transplant graft survival? YES, suggests a 15-year retrospective study of 2,277 transplant recipients. Those who did PD prior to transplant were 34.5% more likely to survive, and had less frequent rejection. Living donor kidneys did best among patients who received transplants before starting dialysis—or did PD.
Read the abstract » | (added 2019-11-16)
Tags: Kidney Transplant, Modality, PD, HD, Hemodialysis, Peritoneal Dialysis
Proton Pump Inhibitors Increase Peritonitis Risk in PD
In a single-center, 36-month retrospective look at 230 Japanese PD patients, those who took PPIs were 72% more likely to develop peritonitis than those who did not.
Read the abstract » | (added 2019-11-16)
Tags: PD, PPIs, Peritonitis, Proton Pump Inhibitors
Is PD a Good Option for Patients with Liver Cirrhosis?
A study matched patients with cirrhosis who did PD, patients with cirrhosis who did HD, and non-cirrhosis patients on PD by age, sex, catheter placement date, and diabetes status. PD technique failure and all-cause mortality were similar between patients with and without cirrhosis.
Read the abstract » | (added 2019-10-14)
The Role of Frailty in Home Dialysis
Evaluation of frailty among 109 home dialysis patients revealed a greater than 2-fold increase in risk of a composite outcome that included technique failure and all-cause death. Weakness and weight loss were both linked with higher risk. “Assessing frailty as part of the clinical evaluation for home dialysis therapies may be useful for prognostication and clinical management,” report the authors.
Read the abstract » | (added 2019-10-14)
Tags: Frailty, Home Dialysis, All cause Death
PD and Swimming
Australian nurses in 39 PD clinics conducted phone surveys. While only 77% of the clinics advocated swimming, nearly all had patients who did swim, mainly in sea water or a private pool. Covering the exit site and catheter with a waterproof dressing or ostomy bag was recommended, along with routine exit-site care. Several infections were linked with swimming.
Read the abstract » | (added 2019-10-14)
Tags: PD, Swimming, Exit Site, Waterproof, Infections
Home Dialysis: Better Outcomes at Lower Costs
Five years after starting dialysis, the population of Ontario, Canada over age 18 had mean 30-day PD costs 50% lower than in-center HD—and home HD costs 64% lower than in-center. After adjusting for covariates, home HD cost the least and had the highest survival (80%) vs. 52% on PD and 42% on in-center HD.
Read the abstract » | (added 2019-10-14)
Tags: Home Dialysis, PD Cost, HD Cost, HD Survival
Sudden Cardiac Death (SCD) in PD vs. HD
A Korean registry analysis of 132,083 dialysis patients between 1985 and 2017 found that SCD caused 19.6% of the 34,632 deaths. Even after adjusting for age and significant comorbidities, HD was independently associated with SCD, as was diabetes.
Read the abstract » | (added 2019-10-14)
Tags: SCD, Sudden Cardiac Death, PD, HD
PD Outcomes under the Medicare Expanded Dialysis Prospective Payment System
A Medicare change in 2011 may have increased the likelihood that clinics would expand PD to a broader population. Did this affect outcomes? A prospective cohort study compared 10,585 patients who started PD before payment reform, 7,832 interim patients, and 18,742 during the reform period. With similar demographics, more patients were treated in clinics with less PD experience—and these clinics had higher PD discontinuation rates. But, PD discontinuation fell overall, and mortality risk was stable.
Read the abstract » | (added 2019-10-14)
Tags: Expanded Dialysis Prospective Payment System, PD, Medicare
A Patient on Home HD for 45 Years
A 62-year old Mississippi woman, one of the first home HD patients of Dr. John D. Bower, is reported to have been on home HD for 45 years now, a record.
Read the abstract » | (added 2019-09-11)
Tags: Home Hemodialysis, Quality Of Life, Long term Survival