Why Seniors Choose HD vs. PD

Older people may be equally suited for PD or HD, so what guides their choice? In an interview study, PD was selected by those wanted convenience and a normal life. HD, on the other hand, was chosen by those who were afraid and wanted security. EDITOR’S NOTE: Of course patients are afraid! We need to help ease their fears before we educate them about their options.

Read the abstract » | (added 2016-11-10)

Tags: Hemodialysis

Patient Peritonitis Perspectives

Australian researchers conducted interviews with 29 current or past PD patients to gain insights into the prevention of peritonitis. The four themes identified were the constant need for vigilance, invading harm from infection, incapacitating lifestyle interference, and exasperation with hospitalizations. The authors concluded that education about peritonitis and lifestyle impacts of PD may be helpful.

Read the abstract » | (added 2016-10-13)

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Case Study Offers Hope for Successful EPS Treatment

Working on the hypothesis that encapsulating peritonitis has TWO causes (a deteriorating peritoneum and inflammation), researchers tried a new treatment approach—and it worked. Combining sirolimus, a low-dose corticosteroid, and intradialytic parenteral nutrition helped a patient.

Read the abstract » | (added 2016-10-13)

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In the Netherlands, High-Dose HD Holds Up to Cost Scrutiny

Is high-dose HD cost-effective?  A new Dutch study finds that while conventional home HD (three treatments per week) may be the most cost-effective, since high-dose HD is twice as much treatment, "from a payer’s perspective, high dose HD should be offered as a home therapy to obtain its clinical benefits in a cost-effective manner."

Read the abstract » | (added 2016-10-13)

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US Home Dialysis Use by Racial and Ethnic Minorities

Are African Americans about 50% less likely to do home therapies across the entire US—or are certain states less well-represented than others?  An analysis of 369,164 Medicare fee-for-service dialysis patients was analyzed by state. African American patients were the least likely to use PD in every US region except Massachusetts. Across the US, all minorities were less likely to use home HD than Caucasians, but Asians were more likely to use home HD in the Midwest.

Read the abstract » | (added 2016-10-13)

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PD Dose Needs Adjustment for Activity Level

Is one PD Kt/Vurea level the same in a sedentary older person as it is in an active younger one?  NO, finds a new study that looked at energy expenditure in 148 PD patients. Adjusting Kt for resting energy use showed that women received less PD than men, younger people received less PD than older ones, and working people received less PD than unemployed ones—among other significant differences.

Read the abstract » | (added 2016-10-13)

Tags: Hemodialysis

Risk Factors for Encapsulating Peritoneal Sclerosis (EPS)

In a study of 703 PD patients between 1980 and 2015 at two centers, the 44 who developed EPS were more likely to have had a history of peritonitis, which rose with the duration of time on PD. The use of biocompatible PD fluid reduced the risk.

Read the abstract » | (added 2016-09-14)

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Exploding PD Myths

Misconceptions about who will be a “good PD patient” have unnecessarily limited PD updake, increased transfers to in-center HD, and raised costs. Get the straight story!

Read the abstract » | (added 2016-09-14)

Tags: Hemodialysis

10-year Experience with Incremental PD

People who start dialysis with residual function may not need full-on, four- exchanges-per-day PD. This center reports excellent clinical experiences using incremental PD, 1-2 dwells per day, until residual function dropped (a mean of 17 months), finding no differences between an incremental and a standard PD start—and better maintenance of residual function.

Read the abstract » | (added 2016-09-14)

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Which Tidal PD Setting is Most Efficient?

A study of 5 different tidal prescriptions for automated PD (APD) were used with six low-average and six high-average transporters. There were significant differences in urea and creatinine clearance between the prescriptions.

Read the abstract » | (added 2016-09-14)

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