The Impact of Abdominal Adhesions on PD

A total of 758 people getting laparoscopic PD catheter placement in Canada; 27% with adhesions, were enrolled in a study of PD catheter complications. Among the adhesion group, 17% had catheter complications such as abdominal pain or flow restriction, vs. 10% in the group without adhesions. Yet, the majority did not have complications, even with adhesions.

Read the abstract » | (added 2024-01-17)

Tags: Intra abdominal Adhesions, Peritoneal Dialysis, Catheter Complications, Laparoscopic PD Catheter Placement

Progression of Brain Atrophy in PD vs. HD

A follow-up study of brain atrophy progression followed 73 PD and 34 HD patients who had brain MRIs, including 42 PD and 25 HD patients who had a second brain MRI. Brain grey matter volume measurement demonstrated faster progression of brain atrophy in PD than in HD, independent of potential confounders.

Read the abstract » | (added 2024-01-17)

Tags: Brain Atrophy, PD, HD

Patient Training and Safety with Home HD

Despite the paramount importance of safety with home HD, there is “a surprising lack of literature” about it and no consensus on optimal training techniques or schedules, contend the authors of a new study.

Read the abstract » | (added 2024-01-17)

Tags: Home HD, Training Techniques, Home HD Training Schedules

Dietary Protein Intake and Survival on PD

Among 668 stable PD patients followed for up to 13 years, quarterly 3-day dietary records were collected for 2 ½ years. Dietary protein intake greater than 0.8 g/Kg/day improved long-term survival.

Read the abstract » | (added 2023-12-15)

Tags: Dietary Protein, Survival, PD

Lessons from Almost 15,000 PD Catheter Placements

Of the various PD catheter placement techniques, laparoscopy had higher 6-month mechanical complications, exit site infections, revision, and removal rates, while fluoroscopy had higher rates of sepsis and death. Open surgery had higher rates of catheter displacement.

Read the abstract » | (added 2023-12-15)

Tags: PD Catheter Placement Technique, Laparoscopy, Mechanical Complications, Exit Site Infections, Revision, Removal Rates, Fluoroscopy, Sepsis, Death

A Home Dialysis Primer for Internists

Since PD and home HD are increasing in use due to their clinical and practical advantages, clinicians need to understand these treatments. A new primer in the Annual Review of Medicine will help them do just that.

Read the abstract » | (added 2023-12-15)

Tags: Home Dialysis, HD, PD, Home Dialysis Primer

How Sugar Harms the Peritoneum and Causes Fibrosis

HOW does sugar harm the peritoneum? An RNA sequencing study looked at peritoneal endothelial cell (EC) function in mice and human ESRD cells in the presence or absence of glucose. In mice, glucose increased EC proliferation, permeability, and inflammation. Blocking glucose caused a therapeutic benefit. Human cells reacted in a similar way.

Read the abstract » | (added 2023-12-15)

Tags: Sugar, Glucose, Peritoneum, RNA Sequencing, Endothelial Cell Function

High Ultrafiltration Volumes May Contribute to Pruritus

Could changes in skin perfusion and inflammation play a role in dialysis itching? An observational study of 392 patients looked at self-reports of pruritus severity and UF volumes. BMI and UF volume independently predicted pruritis severity.

Read the abstract » | (added 2023-12-15)

Tags: Ultrafiltration Volume, UF Volume, BMI, Pruritus, Skin Perfusion, Inflammation

Should We Drop PD “Adequacy” as a Measure?

New ISPD guidelines suggest that patient well-being should be the goal of the PD prescription, not target urea or creatinine clearances. Identification of solutes that cause uremic symptoms could help devise ways to limit their accumulation.

Read the abstract » | (added 2023-12-15)

Tags: ISPD Guidelines, Patient Well being, PD Prescription, Uremic Symptoms

The PD Surprise Question Predicts Transfer to HD

An observational study of 1,275 PD patients in 35 programs asking the RN and treating nephrologist, “Would you be surprised if this patient transferred to HD in the next 6 months?” identified 15% as high risk. After 6 months, the transfer to HD rate was nearly four times higher in the high risk group than the low risk group.

Read the abstract » | (added 2023-12-15)

Tags: PD, Home Dialysis, Peritoneal Dialysis, Surprise Question