Journal Watch
Fewer Hip Fractures with PD than Standard In-Center HD: Metaanalysis
Analysis of five cohort studies totalling more than 1.2 million ESRD patients found that those doing HD had a 61% higher risk of hip fracture than those doing PD.
Read the abstract » | (added 2019-02-14)
Tags: Hip Fractures, PD, In center HD
Most Cost Effective Dialysis Options: Metaanalysis
An analysis of 16 economic studies from both high- and low-income countries determined that home dialysis options are less costly and offer comparable—or better—health outcomes than in-center HD. Quality of life concerns were rarely investigated, however.
Read the abstract » | (added 2019-02-14)
Tags: Economic Studies, HD, Cost, Dialysis Options, Health Outcomes
Low-volume Tidal PD for Urgent Starts
A randomized, prospective trial was done to see if tidal PD (TPD) would improve outcomes among 27 urgent start PD patients, vs. 22 who did low-volume intermittent PD. After follow up for up to 2 years, the TPD group did have significantly fewer catheter complications. Both options had about the same technique survival.
Read the abstract » | (added 2019-01-11)
Tags: Automated Peritoneal Dialysis, Tidal Peritoneal Dialysis, Intermittent Peritoneal Dialysis, Complications
PD Technique Survival by Equipment Manufacturer
An Australia/New Zealand study of all 16,575 new PD patients between 1995 and 2014 compared PD cyclers made by Baxter, Fresenius, or Gambro. Gambro users had the fewest days to technique failure among the 72% who had it, followed by Fresenius, and then Baxter.
Read the abstract » | (added 2019-01-11)
Tags: Peritoneal Dialysis Systems, Comparison, Technique Failure, Patient Survival
Impact of High Protein Diets on Residual Kidney Function in PD
Does a high-protein diet cause a faster loss of residual kidney function for PD patients? An observational study of 336 patients for at least 6 months suggests that it may.
Read the abstract » | (added 2019-01-11)
Tags: Protein Intake, Residual Kidney, Peritoneal Dialysis, PD
Home Dialysis Barriers Examined (Again)
Since the NKF-KDOQI is a latecomer to the home dialysis party (at least for home HD), they started at the beginning with a conference identifying barriers to starting and keeping patients at home. Not surprisingly, cursory education, and lack of exposure to home options or support for care partners were implicated.
Read the abstract » | (added 2019-01-11)
Tags: Home Dialysis, KDOQI, Barriers, Patient Support
Icodextrin Reduces PD Stroke Risk
Stroke risk was compared in PD patients in Taiwan who did or did not use icodextrin. Icodextrin users had a lower risk and incidence of strokes than non-users.
Read the abstract » | (added 2018-12-14)
Tags: Stroke, PD Patients, Icodexytrin
Protein Clearance Predicts Mortality on PD
Protein clearance on PD may be a marker of peritoneal inflammation. Among 711 PD patients followed for at least one year, each 10mL/day rise in protein clearance was linked with a 10.4% increase in the risk of all-cause mortality (p=0.008). Protein clearance was linked with serum albumin and C-reactive protein levels.
Read the abstract » | (added 2018-12-14)
Wanted: A Paradigm Shift from Urea to Sodium Removal
When nephrology icon Zyblut Twardowski talks, we listen! When dialyzors in Seattle in the 1960s got 30 hours a week of dialysis, the mortality rate was 10%. Since then, short treatments—justified by the flawed NCDS study—were driven by the equally flawed notion of Kt/V urea.
Read the abstract » | (added 2018-12-14)
Tags: Kt/V Urea, Mortality Rate, Sodium Removal, Dialysis Quality, NCDS, RCT
Medicare Reimbursement Has Driven More PD
Changes to the Medicare Prospective Payment System (PPS) in 2011 to create financial incentives for PD have worked, finds a new analysis of 6,433 dialysis clinics before and after the change. Since 2011, 6% more clinics offered PD, and program size increased from an average of 5.7 patients to 6.9. Non-urban, chain, and larger clinics were significantly more likely to have changed their PD practices in response to the PPS change.
Read the abstract » | (added 2018-12-14)
Tags: Medicare, Prospective Payment System, Peritoneal Dialysis, Quality Of Life