Journal Watch
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Patients Prefer Home Therapies
Researchers from New Zealand asked 143 CKD patients expected to need dialysis within a year about their preferences. Patients significantly preferred home treatments, due to flexible schedule, better well-being, and longer survival—and were even willing to pay as much as $400 per month out-of-pocket for extra nursing support. Read the abstract.
Read the abstract » | (added 2017-11-13)
Tags: Confidence Intervals, Health Expenditures, Humans, Life Expectancy, Odds Ratio, Patient Preference, Adult, Choice Behavior
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Views of Patients vs. MDs Re: Important Dialysis Outcomes
An international 3-round Delphi survey that started with 202 patients and care partners and 979 renal professionals aimed to generate a consensus-based prioritized list of core outcomes for HD trials. Not surprisingly, patient/care partner priorities differed dramatically from those of professionals: patients largely valued quality of life outcomes, while professionals focused on clinical ones.
Read the abstract » | (added 2017-10-13)
Tags: What Is The Best Dialysis Option For Me, Making Dialysis Better
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The Impact of AGEs on the Gut Microbiome in PD
The Impact of AGEs on the Gut Microbiome in PD Advanced glycation endpoints (AGEs) cause inflammation and are linked with heart disease. A new PLoS One paper reports on a pilot trial of 20 PD patients who routinely ate a high-AGE diet. Ten were randomized to eat as usual, while 10 had their meals AGE-restricted for a month. Gut bacteria analysis found major shifts in the experimental group that could have clinical importance.
Read the abstract » | (added 2017-10-13)
Tags: Education Issues: For Patients And Professionals, Fistulas, Grafts And Catheters (including PD)
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More CMS Incentives Needed to Boost Home Dialysis
More CMS Incentives Needed to Boost Home Dialysis Have changes in the ESRD Prospective Payment System (“bundle”) designed to increase the use of home dialysis been successful? A new analysis of USRDS data from 2006 to 2013 found that bundling injectable medications and paying for home training did move the needle a bit—but not enough. Compared to patients with other insurance who had a 4.1% increase in home dialysis during this period, Medicare beneficiaries had a non-significant 5.8% rise.
Read the abstract » | (added 2017-10-13)
Tags: Education Issues: For Patients And Professionals, Choosing The Right Path Through ‘The System’
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Why Do Patients Think PD is Underused?
A survey of 920 HD patients in Saudi Arabia found that lack of appropriate counseling and education by nephrologists was an important reason why they did not choose PD.
Read the abstract » | (added 2017-10-12)
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Obesity and PD Catheter Function
It is a common belief that obesity is a contraindication to PD—but a new study of 231 patients who were demographically similar except for weight found otherwise. Compared to normal weight patients, those who were overweight or obese had no signficant differences in catheter dysfunction or complications—regardless of the placement technique used.
Read the abstract » | (added 2017-10-12)
Tags: Education Issues: For Patients And Professionals, Fistulas, Grafts And Catheters (including PD)
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Canadian Home Dialysis by Race: Access vs. Outcomes
Unlike the US, Canada’s universal healthcare system does not limit access to home dialysis by racial minorities. However, compared to whites, Asians, blacks, and some others had better survival on PD, while Aboriginals had poorer survival. No survival differences were found among home HD patients based on race—but event numbers were lower.
Read the abstract » | (added 2017-09-15)
Tags: Choosing The Right Path Through ‘The System’ Education Issues: For Patients And Professionals
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Bone Mineral Balance in Short Daily HD: A Cautionary Tale
A new case report suggests that bone mineral balance may need extra attention for those doing short daily HD. A patient who had multiple fractures and bone pain severe enough to require a wheelchair for more than a year was found on biopsy to have osteomalacia, likely due to chronically low levels of serum phosphorus and calcium. Increasing these minerals in the dialysate enabled the patient to leave the wheelchair and walk pain-free.
Read the abstract » | (added 2017-09-15)
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Predicting Cardiovascular Risk in PD
What are the cardiovascular risk factors in PD? In a small (N=112) retrospective study among incident PD patients followed for more than a year, traditional risk factors did not predict heart problems—however, excess blood volume, low serum albumin levels, and mitral valve calcification did.
Read the abstract » | (added 2017-09-15)
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PD in PKD?
There is yet more evidence that people with PDK can successfully do PD. Researchers in Peking analyzed survival data from people with PKD between1993 and 2015 on PD vs. HD. Additionally, they matched PD patients who did and did not have PKD. Neither PD nor PKD independently predicted mortality.
Read the abstract » | (added 2017-09-15)