Journal Watch
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Progress in PD Fluid
While glucose-based PD fluids are inexpensive, non-physiological PD fluid can, ironically, damage the peritoneum and cause devastating complications including peritoneal fibrosis and encapsulating peritoneal sclerosis (EPS). Neutral pH and solutions low in glucose degredation products (GDPs) help preserve peritoneal integrity and residual renal function, while using other osmotic agents such as icodextrin can improve ultrafiltration. Alternative buffers are also helpful.
Read the abstract » | (added 2025-03-13)
Tags: PD Fluid, Glucose Degredation Products, Icodextrin, Peritoneal Fibrosis, Encapsulating Peritoneal Sclerosis
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Uptake of Home Dialysis After Kidney Transplant Failure by Sex
An ANZDATA registry study analyzed dialysis after transplant failure of 3,521 patients from 2000 to 2020. While 38% of the patients were female, 12 months after transplant failure, 14% were using PD and 12% were using home HD. Males were 55% less likely to choose PD after transplant failure and 66% more likely to choose home HD. These disparities were greater in low SES regions.
Read the abstract » | (added 2025-03-13)
Tags: Gender, PD, Home HD, Transplant Failure
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Impact of Extended HD with a Liberalized Diet on Protein Energy Wasting
An 8-year longitudinal study assessed BMI and creatinine generation rate for 402 patients who started extended-hours HD (>18 hours/week). Over time, treatment sessions got longer (70% received >21 hours/week). Participants maintained their BMIs and % creatinine generation over time, and the 5-year survival rate was 85%.
Read the abstract » | (added 2025-02-14)
Tags: Extended hours Hemodialysis, Liberalized Diet, Longitudinal Study, Protein energy Wasting
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Home Sweet Home Dialysis
Home Sweet Home (HSH) is a new Canadian program where current home dialysis patients share their lived experiences with prospective patients in a home-like setting. Of 291 participants between 2015 and 2019, 92% were interested in a home modality, noting that they valued patients’ real-life perspective and felt less anxious. At follow-up, 25% were doing home dialysis, 24% had a transplant, and the remaining survivors were dialyzing in-center.
Read the abstract » | (added 2025-02-14)
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Reasons for Switching from PD to HD
A retrospective analysis of 15,974 French PD patients between 2002 and 2018 found 6,835 deaths, 5,108 transfers to HD, and 3,094 transplants. Nurse-assisted PD reduced the risk of transfer to HD due to infection in the first 18 months as well as adequacy after 6 months. Surprisingly, CAPD had a higher risk of transfers to HD for mechanical issues than APD in the first 6 months—but a lower risk of issues after 18 months. Suboptimal starts had more psychosocial issues.
Read the abstract » | (added 2025-02-14)
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Use of Plastic Cannulae for Nocturnal HD Wins Award
In Singapore, nurses noted that 30% of in-center nocturnal HD patients dropped out due to fear and pain from steel needles—so they switched to plastic cannulae. This change resulted in 85% less anxiety and 63% less fear.
Read the abstract » | (added 2025-02-14)
Tags: In center Nocturnal HD, Fear, Pain, Anxiety, Steel Needles, Plastic Cannulae
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Anxiety, Symptom Burden, and Quality of Life (QOL) on PD
Survey responses from 305 PD patients measured anxiety levels, symptom burden, and QOL. Participants had an average of 5.9 to 10.5 symptoms that negatively correlated with QOL. Anxiety explained 38.9% of the symptom number and 33.3% of the symptom-related distress.
Read the abstract » | (added 2025-02-14)
Tags: Anxiety Levels, Symptom Burden, QOL
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Psychosocial Concerns May Impact Minority Uptake of PD
Analysis of qualitative interview data from 113 patients in Bronx, NY who completed dialysis modality education found gaps in the areas of support for the emotional trauma of an ESKD diagnosis and lack of a program to reduce anxiety about PD responsibilities, along with failure to address structural barriers to PD.
Read the abstract » | (added 2025-02-14)
Tags: Qualitative Interview Data, Dialysis Modality Education, Patient Support, Emotional Trauma, ESKD
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Survival on HD vs. Immediate-start PD
After reviewing medical records from 911 incident dialysis patients from 2005 to 2023, 140 HD and 140 immediate start PD patients were selected for 1:1 propensity score matching. While long-term survival was comparable between the two modalities, non-diabetic patients had significantly higher survival on immediate start PD than HD.
Read the abstract » | (added 2025-01-13)
Tags: HD, Immediate start PD, Survival, Propensity Score
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Peer Support + Nurse-led Modality Education Increases Patient Choice of PD
Of 238 patients from 500 outpatient clinics in 2018 to 2020, 112 received both nursing education (NE) and peer support to make an ESKD modality choice. The combination helped patients make informed choices that aligned with their values and preferences.
Read the abstract » | (added 2025-01-13)
Tags: Peer Support, Nursing Education, Modality Choice, Modality Education