Journal Watch
Predicting UF Failure in PD
A study in two Spanish hospitals tested a software approach to predicting PD UF failure in 183 PD patients. Using biomarkers and clinical data, the MAUXI program was able to predict UF failure and cardiovascular events.
Read the abstract » | (added 2025-03-13)
Tags: Software Predicting, PD UF Failure, MAUXI
Laparoscopic vs. Open PD Catheter Placement
Analysis of 11,731 PD catheter insertions from 2013 to 2018 examined the association between type of placement, complications, length of hospital stay, and mortality. During the 5-year period there was a significant increase in laparoscopic PD insertions. Complications were similar between groups, with slightly longer hospital stays for open placements.
Read the abstract » | (added 2025-03-13)
Tags: PD Catheter, Complications, Laparoscopic PD Insertions
Home Dialysis in Finland
Prevalence of home dialysis has dropped in the past decade in Finland, despite its better survival compared to in-center HD. Semi-structured surveys for nephrologists, nephrology nurses, and patient associations endeavored to understand why. Nursing shortages and patient comorbidities received wide agreement as barriers, and clinicians believed that starting in-center reduces the odds of switching to home treatments later. For patients, financial burdens and impact on care partners were critical, as was “bringing hospitals home” or living in small spaces.
Read the abstract » | (added 2025-03-13)
Tags: Home Dialysis, Survival, Modality, Barriers
The Impact of Rural Outreach in West Virginia on Home Dialysis
Of 22,408 WV patients who started dialysis between 1965 and 2020, 13% overall started with a home modality—but this figure was 18% in counties that had a rural outreach kidney care clinic.
Read the abstract » | (added 2025-03-13)
Tags: Dialysis, Home Modality, Rural Outreach
Progress in PD Fluid
While glucose-based PD fluids are inexpensive, non-physiological PD fluid can, ironically, damage the peritoneum and cause devastating complications including peritoneal fibrosis and encapsulating peritoneal sclerosis (EPS). Neutral pH and solutions low in glucose degredation products (GDPs) help preserve peritoneal integrity and residual renal function, while using other osmotic agents such as icodextrin can improve ultrafiltration. Alternative buffers are also helpful.
Read the abstract » | (added 2025-03-13)
Tags: PD Fluid, Glucose Degredation Products, Icodextrin, Peritoneal Fibrosis, Encapsulating Peritoneal Sclerosis
Uptake of Home Dialysis After Kidney Transplant Failure by Sex
An ANZDATA registry study analyzed dialysis after transplant failure of 3,521 patients from 2000 to 2020. While 38% of the patients were female, 12 months after transplant failure, 14% were using PD and 12% were using home HD. Males were 55% less likely to choose PD after transplant failure and 66% more likely to choose home HD. These disparities were greater in low SES regions.
Read the abstract » | (added 2025-03-13)
Tags: Gender, PD, Home HD, Transplant Failure
Home Dialysis + Person-centered Care
A scoping review identified 9,443 articles about the intersection of person-centered interventions (PCI) and home dialysis. The 16 that met the inclusion criteria included 13 PCIs; eight to involve patients in modality choice, six to involve them in their treatment, and one to involve patients in post-treatment-choice decisions. Five found a correlation between a PCI and the number of patients using home dialysis.
Read the abstract » | (added 2025-03-13)
Tags: Home Dialysis, Person centered Interventions, Modality Choice
Psychosocial Concerns May Impact Minority Uptake of PD
Analysis of qualitative interview data from 113 patients in Bronx, NY who completed dialysis modality education found gaps in the areas of support for the emotional trauma of an ESKD diagnosis and lack of a program to reduce anxiety about PD responsibilities, along with failure to address structural barriers to PD.
Read the abstract » | (added 2025-02-14)
Tags: Qualitative Interview Data, Dialysis Modality Education, Patient Support, Emotional Trauma, ESKD
Impact of Extended HD with a Liberalized Diet on Protein Energy Wasting
An 8-year longitudinal study assessed BMI and creatinine generation rate for 402 patients who started extended-hours HD (>18 hours/week). Over time, treatment sessions got longer (70% received >21 hours/week). Participants maintained their BMIs and % creatinine generation over time, and the 5-year survival rate was 85%.
Read the abstract » | (added 2025-02-14)
Tags: Extended hours Hemodialysis, Liberalized Diet, Longitudinal Study, Protein energy Wasting
Reasons for Switching from PD to HD
A retrospective analysis of 15,974 French PD patients between 2002 and 2018 found 6,835 deaths, 5,108 transfers to HD, and 3,094 transplants. Nurse-assisted PD reduced the risk of transfer to HD due to infection in the first 18 months as well as adequacy after 6 months. Surprisingly, CAPD had a higher risk of transfers to HD for mechanical issues than APD in the first 6 months—but a lower risk of issues after 18 months. Suboptimal starts had more psychosocial issues.
Read the abstract » | (added 2025-02-14)