Journal Watch
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Organizational Culture and Home Dialysis Uptake
An ethnographic study of dialysis clinic culture was conducted at four clinics in England with average or high rates of home dialysis and maximal geographic, ethnic, and socioeconomic diversity. Three themes identified were encouraging the patient voice and providing individualized support, ensuring home dialysis access (minimalizing eligibility assumptions), and achieving sustained change based on benefits for patients.
Read the abstract » | (added 2025-01-13)
Tags: Dialysis Clinic Culture, Home Dialysis Access, Patient Benefits
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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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Probiotics in PD
While the gut microbiome can be key to challenges PD patients often face, there have been little specific data on the use of probiotics by PD patients. A review article summarizes current knowledge, explores how interventions could improve PD outcomes, outlines clinical effectiveness data, and suggests future research directions.
Read the abstract » | (added 2025-01-13)
Tags: Gut Microbiome, PD Outcomes, Probiotics
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Advancing American Kidney Health Initiative Did Not Impact Public Awareness
In 2019, the AAKHI aimed to increase the use of home dialysis. Analysis of U.S. Google Trends data from 2013 to 2021 for home dialysis terms found an increase in searches when the AAKHI was first announced, followed by flat or declining searches. The authors concluded that the AAKHI did not impact public information-seeking and targeted education initiatives may be needed.
Read the abstract » | (added 2025-01-13)
Tags: Advancing American Kidney Health Initiative, AAKHI , Public Awareness
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Impact of PD Exchange Volume/Day on Outcomes
A DOPPS cohort study in Japan divided patients into two groups by daily PD dialysate volume (<4L/day; n=98 or >4L/day; n=244). Despite demographic differences between the groups, there were no significant differences in transfers to HD, mortality, hospitalization, peritonitis, or patient-reported outcomes based on volume—thus less volume may be more cost effective.
Read the abstract » | (added 2024-12-11)
Tags: Dialysate Volume, Peritoneal Dialysis Outcomes, Mortality, Patient reported Outcomes
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Do Ketoanalogue (KA) Supplements Preserve Residual Kidney Function in PD?
A 1-year, six center, randomized, double-blind trial investigated the impact of KA supplements on RKF in 153 CAPD patients vs. placebo. For patients with early PD initiation, the KA group had a significantly lower decline in RKF. No differences were found in RKF decline in those with late PD starts or in PD adequacy, peritoneal function, nutritional status, or quality of life scores between groups.
Read the abstract » | (added 2024-12-11)
Tags: KA Supplements, Residual Kidney Function, CAPD, Ketoanalogues
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Early Icodextrin (ICO) Use Reduced PD-associated Peritonitis Risk
A group of 82 patients who did PD between 2011 and 2020 were divided into a group (n=21) who received ICO at PD initiation and a group (n=61) who received it later or not at all. Patients were followed until they stopped PD, died, or 3 years passed. PD-associated peritonitis and tunnel infection-free survival rates were significantly better with early ICO use.
Read the abstract » | (added 2024-12-11)
Tags: PD, ICO, Early Icodextrin, Peritonitis, Tunnel Infection free Survival Rates
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Long-term PD vs. HD on Left Ventricular Function
In a small echocardiogram study of long-term dialysis patients (mean of 125.1+35.2 months), 24 CAPD patients and 23 HD patients were assessed for LV function, LVH, and LV geometry. Left ventricle dysfunction, LVH, and deterioration in LV geometry were significantly worse in the PD group.
Read the abstract » | (added 2024-12-11)
Tags: Echocardiogram, LVH, Left Ventricular Hypertrophy, Left Ventricle Dysfunction, CAPD, HD
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An Integrated Home Approach: PD to Home HD
Even in Canada, it is rare (2-6%) that patients who stop PD transfer to home HD. A new review article shares data and describes an integrated home dialysis model that covers patient identification, timely transition planning, and challenges.
Read the abstract » | (added 2024-11-21)
Tags: PD Transfer To Home HD, Transition, Integrated Home Dialysis Model
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Pet Cats and Peritonitis—a Non-starter for PD?
The answer might surprise you. In a retrospective registry study in France, 52 PD patients who developed cat-related peritonitis were matched with 208 controls whose PD peritonitis was due to other causes. After analysis, pet-related peritonitis had lower risks of death or transfer to HD and a higher rate of transplant than other-cause peritonitis. The authors concluded that, while cats may cause peritonitis, having pets at home should not be considered a reason to refuse patients PD.
Read the abstract » | (added 2024-11-21)
Tags: Pets, Cats, Peritonitis, Pet related Peritonitis, PD, Technique Survival