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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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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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
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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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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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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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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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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
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Stepwise PD Starts vs. Conventional PD Starts—Which is Better?
Stepwise Initiation of PD (SIPD) is an approach that uses a gradual introduction to PD (perhaps like incremental PD in the U.S.?). In a retrospective look at 39 SIPD patients vs. 78 conventional PD (CPD) starts during a 13-year period matched for age and sex, early complications and PD catheter survival were similar between groups. But, late complications were significantly lower in the SIPD group. The authors believe SIPD may aid tissue healing and reduce biofilms, which may reduce infections. As always, more studies are needed…
Read the abstract » | (added 2024-11-21)
Tags: Stepwise Initiation Of PD, Incremental PD, Late Complications, Infection, Tissue Healing, Biofilms