Journal Watch
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New Model Could Help Screen PD Patients for CeVD Risk
A new risk score could predict how likely new PD patients are to develop cerebrovascular disease down the road. The strongest predictors of CeVD were blood pressure, total cholesterol, and serum phosphate and sodium levels.
Read the abstract » | (added 2018-08-13)
Tags: Cerebrovascular Diseases, Mortality, Peritoneal Dialysis, Risk Prediction
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Blood Flow Rates and Clinically Meaningful Solute Removal
A prospective study of 17 patients looked at BFRs of 300, 350, and 450 and Kt/V urea, beta-2 microglobulin, and phosphorus when low dialysate flow rates were used. While Kt/V did increase, the impact on B2M and phosphorus were minimal.
Read the abstract » | (added 2018-08-13)
Tags: Daily Hemodialysis, Home Hemodialysis, Kt/V, Blood Flow
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Driving Home Dialysis Takes More Than Money
Are financial incentives enough to change nephrologist practice to favor home therapies? Only a little, finds a comprehensive literature review and an international workshop. Other levers, such as the framework of funding for clinics, nephrologist belief in home treatments, and direct costs to patients (e.g., utilities) may play a role as well.
Read the abstract » | (added 2018-08-13)
Tags: Home Dialysis, Financial Incentives, Nephrologist Practice
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Vascular access for high-risk PD patients
Which PD patients are at risk for technique failure and should proactively have a vascular access placed for HD? A case-control study compared 72 patients who were transferred from PD to HD to 111 controls who stayed on PD, received a transplant, recovered kidney function, or passed away. Low adequacy or serum albumin, hospitalizations, and peritonitis were predictors of a transfer to HD. Read the abstract.
Read the abstract » | (added 2018-07-13)
Tags: PD, Technique, Vascular Access, HD
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Does RRF affect quality of life in CAPD?
The SF-36 was given to 120 adult patients on CAPD for at least 3 months, divided into a group with and without residual renal function. There were no correlations between RRF and total SF-36 scores. However, SF-36 scores did correlate with measures of inflammation, fluid overload, and malnutrition. Read the abstract.
Read the abstract » | (added 2018-07-13)
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Vitamin D and Cinacalcet linked to PD survival—but not residual kidney function
In a retrospective look at 581 PD patients, use of Vitamin D and cinacalcet (which have antiinflammatory properties) were linked with 56% and 54% lower risks of death, respectively. But, neither drug slowed the loss of residual function. Read the abstract.
Read the abstract » | (added 2018-07-13)
Tags: Vitamin D, Cinacalcet, Risidual Function
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Lower B2M levels linked with WORSE survival on PD
Unlike HD, a new study of 725 incident PD patients divided into three beta-2 microglobulin tertiles found that the lowest third of B2m levels was associated with a higher risk of death. The increased risk was especially seen in females; older patients; and those with comorbidities, low BMI, low serum albumin, and less residual kidney function. Read the abstract.
Read the abstract » | (added 2018-07-13)
Tags: PD, B2m, Morbidity Rate
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Nephrologists’ attitudes toward intensified HD
Among German nephrologists, 44% believe there is not enough evidence in favor of intensified HD, whether or not they offer it. Respondents cited a need for more funding and more staff to support the therapy. Among the 44% who did offer the option, most reserved it for patients who were not receiving adequate treatment with conventional HD, and just 19% offered it routinely. Read the abstract.
Read the abstract » | (added 2018-07-13)
Tags: Intensified HD
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Residual Kidney Function and Sleep Apnea Severity in PD
A small (n=15), exploratory study of 15 APD patients with home apnea monitors found obstructive sleep apnea in 33%, which correlated with having less residual renal function.
Read the abstract » | (added 2018-06-12)
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PKD and PD – a Metaanalysis
Among 9 studies totaling 7,197 patients—of whom 882 had polycystic kidney disease—survival was better among the PKD patients. There were no differences in peritonitis or technique survival between those who did and did not have PKD, though those with PKD did have a higher risk of hernias.
Read the abstract » | (added 2018-06-12)
Tags: PKD, PD, Metaanalysis, Polycystic Kidney Disease