Journal Watch
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Year 1 Cognitive Function Better with PD than Standard In-center HD
PD came out the winner over standard in-center HD in a study of cognitive function among 96 HD and 101 PD patients who took cognitive tests at the start and end of their first year of treatment, though both groups saw some improvement.
Read the abstract » | (added 2018-02-15)
Tags: PD, HD, Cognitive Function
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Standard Kt/V urea Targets Less Useful for Home HD
When patients do home HD more often than three times a week, do the Kt/V urea targets still predict outcomes? Not all that well, suggests a new study. Multivariate regression analysis of 109,273 standard in-center HD patients compared to 2,373 home HD patients found that while a lower Kt/V urea (<2.1) did predict higher blood pressure in both groups, it did not predict metabolic control in either group. For those on home HD, a low Kt/V did not predict hospitalization, mortality, or technique failure, though it did for in-center patients. The authors concluded that the current Kt/V urea targets “have limited utility” for home HD.
Read the abstract » | (added 2018-02-15)
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A View of the Dialysis Bundle from a Home Perspective
Don’t miss Dr. Tom Golper’s fascinating take on how the CMS bundle for dialysis services affects home treatments.
Read the abstract » | (added 2018-01-11)
Tags: CMS, Home Treatments
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Connecting Home HD Patients to Care Teams Reduces Dropout
Nx2me is a telehealth platform that allows patients who use NxStage machines for home HD to send data to and communicate with their care teams. Compared to matched controls, 606 Nx2me users were more likely to successfully complete training and less likely to drop out of home HD.
Read the abstract » | (added 2018-01-11)
Tags: Nx2me, Telehealth, NxStage Machines, Home HD
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Peritoneal Membrane Transport and Survival on PD
Among 470 PD patients followed for up to 10 years, high transporters were stable for the first few years, and after 5 years or so, PD adequacy began to slowly fall. The rate of PD transport did not affect patient survival.
Read the abstract » | (added 2018-01-11)
Tags: High Transporters, PD Adequacy, PD Transport, Patient Survival
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Who Matters Most for Modality Choice: Clinicians or Patients?
New Zealand has one of the highest rates of home dialysis use in the world—and they still believe there is room for improvement. An online study of all NZ dialysis clinics coupled with a measure of “decisional power” aimed to see who had the most influence on modality choice. While respondents believed that predialysis nurses were most influential, nephrologists still held the most decisional power—and a one point increase in nephrologist decisional power drove a 6.1% rise in home dialysis use.
Read the abstract » | (added 2017-12-14)
Tags: New Zealand, Home Dialysis, Modality Choice, Patients
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Survival in Those Eligible for BOTH PD or Standard In-center HD
Yes, this is yet another survival comparison. A study of almost a decade of people (N=2,032) starting dialysis at seven Ontario clinics looked at mortality only among those who were judged to be suitable for either PD or standard in-center HD by a multidisciplinary team. Both options offered similar survival.
Read the abstract » | (added 2017-12-14)
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Mycophenolate Mofetil (MMF) and Residual Kidney Function in PD
A small randomized controlled trial of people on PD (N=60) looked at whether the immune-suppressing drug mycophenolate mofetil could help protect residual kidney function. After a year, those who received MMF had significantly higher urine volume and urine Kt/V than controls, with no serious complications.
Read the abstract » | (added 2017-12-14)
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New UK PD Guidelines
Download a free, full-length PDF if you want to learn how PD equipment, training, dose, infection control, and management of complications are done in the UK.
Read the abstract » | (added 2017-12-14)
Tags: PD Equipment, PD Training, Infection Control, PD Dose, PD Complications Management, UK
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In-hospital Patient Education Helps “Crash” Dialysis Starts to Consider PD
As many as half of people who start dialysis in the U.S. each year “crash” into a need for treatment with an urgent, unplanned start—and most receive HD with a catheter. The same is true in Germany, but a new structured education program changed the pattern. Compared to patients who started dialysis urgently before the program, those who were educated were significantly more likely to choose PD.
Read the abstract » | (added 2017-12-14)
Tags: Dialysis, Choose PD, PD Education