Journal Watch
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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
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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
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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
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Longer-term Benefits of Early Start PD
Do people who start PD emergently differ from those with a planned PD start? No, suggests a new study of 154 patients followed for a median of just over a year. Early vs. planned-start patients had similar ages, BMIs, genders, and rates PD drop-out due to peritonitis, catheter dysfunction, and burnout. Only diabetes and BMI >25 were independently associated with PD technique failure—but no differences were found between early and planned starts.
Read the abstract » | (added 2018-12-14)
Tags: Emergent PD, Planned PD, Early Start PD
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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
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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)
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Metaanalysis of Nocturnal HD and Sleep Quality
Nine studies of 286 patients found significantly less sleep apnea and better O2 saturation—but less total sleep time—after switching from conventional to nocturnal HD. Prospective pre-post studies found improved sleep quality, but randomized trials did not. Read the abstract.
Read the abstract » | (added 2018-10-12)
Tags: Sleep Apnea, CHD, NHD, O2 Saturation, Nocturnal HD, Conventional HD, Sleep Quality
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What Makes Home HD Patients Reach for On-Call Support?
A 4-month prospective observational study analyzed the reasons why 58 home HD patients called the on-call nurse or technician. Most calls to nurses were made for clinical issues or machine set-up or alarm questions, some of which required a technician. Most of the technician calls were for machine malfunction, set-up and alarms, or water treatment. Read the abstract.
Read the abstract » | (added 2018-10-12)
Tags: Home Hemodialysis, Independent Hemodialysis, Nocturnal Hemodialysis, Short Daily Hemodialysis
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Nocturnal HD vs. Transplant: Health-related Quality of Life Compared
In a small study, transplant candidates using nocturnal HD (n=41) and transplant patients (n=31) took the KDQOL-short-form survey of health-related quality of life (HRQOL). Those with transplants had significantly higher “effects” of kidney disease scores than those on nocturnal HD. The other domains were not significant. Read the abstract.
Read the abstract » | (added 2018-10-12)
Tags: Transplant, Nocturnal HD, Kdqol, HRQOL, Effects Of Kidney Disease
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Metaanalysis of PD for Kidney Failure due to PKD
Polycystic kidneys may displace room for PD fluid, so can PD be a viable treatment option? A metaanalysis of 12 studies and more than 17,000 patients found…maybe. PD outcomes were about the same for those with PKD as with other primary kidney diseases, and some can do PD. More research is needed to determine who is suitable. Read the abstract.
Read the abstract » | (added 2018-10-12)
Tags: Dialysis Adequacy, PD associated Complications, Peritoneal Dialysis, Polycystic Kidney Disease