Encapsulating Peritoneal Sclerosis (EPS) Incidence and Outcomes

A new Scottish registry study found that 2.8% of PD patients between 2000 and 2007 (n=1,238) developed EPS. The rate rose from 1.1% by year 1 to 3.4% at year 3, 8.8% at year 4, 9.4% at year 5, and 22.2% by year 7. The authors note that “continuing PD beyond 3 years results in an exponential rise in the risk of developing EPS and deciding whether this risk is acceptable should be made on an individual patient basis.”

Read the abstract » | (added 2016-08-09)

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Which is More Cost Effective, PD or Standard In-Center HD?

If you’ve been reading this site, you won’t be surprised to learn that yet another study has found PD to be more cost-effective than standard in-center HD. A cross-sectional analysis was done on matched pairs of incident PD and HD patients (N=4,285) in Taiwan who were followed for up to 14 years. While the quality-adjusted life expectancy was almost equal, HD costs were much higher.

Read the abstract » | (added 2016-08-09)

Tags: Hemodialysis

Fallopian Tubes and PD Catheter Problems

In women, fallopian tubes can be an unrecognized cause of PD catheter malfunction. This case report study describes five episodes of catheter malfunction in four female patients.

Read the abstract » | (added 2016-08-09)

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Silk Filter for the PD WAK

A urease silk fibroin filter has been tested with a wearable artificial kidney (WAK) for PD. In lab analysis, the filter removed more than 50% of urea from a 50 mg/dL urea solution, and 90% after 24 hours.

Read the abstract » | (added 2016-08-09)

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Overhydration and Mortality Risk on PD

When PD does not remove enough water, the resulting overhydration is a major risk factor for death. A study of 54 PD patients between 2008 and 2015 measured with bioimpedance technology were divided into normohydrated and overhydrated groups. Older age, low diastolic blood pressure and overhydration predicted mortality.

Read the abstract » | (added 2016-08-09)

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French Patients on Daily HD

Daily HD is relatively new to France—yet this study was able to include 753 patients who started on the therapy between 2003 and 2012. Two-thirds had switched to daily HD from another option. Younger patients (<64) had better survival (72.6% vs. 31%) and were more likely to receive a kidney transplant than older patients (>64).

Read the abstract » | (added 2016-08-09)

Tags: Hemodialysis

A New Way to Correct PD Catheter Malposition and Blockage

Researchers in China developed a new, minimally invasive technique to reposition and unblock PD catheters. Tested in 16 PD patients, a surgeon made a small (3cm) incision under local anesthesia, disected the tissue, and pulled out the catheter. Adhesions were separated and a new catheter placed with forceps and stitched in place. After 6 months, all of the catheters were working.

Read the abstract » | (added 2016-07-12)

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For HD Survival, Home Beats In-Center

An observational study looked back at 41 incident patients starting home HD and matched them to patients starting in-center HD by sex, age, comorbidity, and start date. Mean survival on home HD was 17.3 years, vs. 13 years in-center. Home HD patients also had significantly lower phosphate levels and did not require blood pressure medications.

Read the abstract » | (added 2016-07-12)

Tags: Hemodialysis

Nocturnal HD Improves Nutritional Status

A metaanalysis was conducted of 9 studies with 229 patients who switched from standard to nocturnal HD. Those on nocturnal HD had significantly higher levels of serum albumin and protein and energy intake.

Read the abstract » | (added 2016-07-12)

Tags: Hemodialysis

Independence, Flexibility and Quality of Life Matter to Patients

For the PCORI-funded Empowering Patients on Choices for Renal Replacement Therapy (EPOCH-RRT), 180 people not yet on dialysis or using standard HD or PD were interviewed to identify the factors in their choice of a dialysis option. Independence, quality and quantity of life, and daily schedule flexibility mattered most—and 47% of those on standard HD said the choice had not been theirs. (NOTE: Ironically, the EPOCH-RRT decision aid omits home HD, an option that offers independence, quality of life, better survival, and schedule flexibility, as we have blogged here and here).

Read the abstract » | (added 2016-07-12)

Tags: Hemodialysis