Journal Watch
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A Post-op Surgical Girdle for Pain and Catheter Tunnel Infections in Urgent Start PD
Urgent start PD can be associated with pain and tunnel infections. In a study of 85 consecutive PD catheter placements, a surgical girdle was used from days 1-3 while patients were supine. Among the 23 patients who completed pain surveys, the girdle helped significantly. Tunnel infections were reduced as well.
Read the abstract » | (added 2019-11-16)
Tags: Urgent Start PD, Pain, Tunnel Infection, PD Catheter, Surgical Girdle
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Tablo HD Machine Safe and Effective at Home and In-center
Safety and efficacy human trials of the easy-to-use Tablo were conducted with 28 participants who received 4 treatments per week in-center and then at home for a total of 21 weeks. Home adherence (99%) was slightly better than in-center (96%), with average prescribed—and delivered—treatments of 3.4 hours, and an average weekly standard Kt/Vurea of 2.8 in both settings. Adverse events were not related to the Tablo, and alarm resolution time was 8 seconds in-center and 5 seconds at home.
Read the abstract » | (added 2019-11-16)
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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
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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
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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
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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
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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
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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
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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
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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