Journal Watch
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Should PD catheters be fixed in place?
PD catheters that migrate may need to be moved or replaced. In a new study from Japan, 16 patients had the usual PD catheter placement, and 25 had their catheters placed using a fixation technique. The fixed catheters were far more likely to be in the right position, and less likely to move out of position. Complication rates were similar for both groups.
Read the abstract » | (added 2014-08-04)
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For older patients, PD offers quality of life boost
Compared to younger people, those over age 65 on PD reported better quality of life, even after adjustment for case mix and comorbidities. Levels of anxiety and depression were about the same between older and younger patients. Those who used a cycler for PD reported fewer symptoms. The authors conclude that “Patients across different age groups should be given non-biased information about both peritoneal dialysis modalities and individual preferences should be elicited and carefully considered by healthcare providers.”
Read the abstract » | (added 2014-08-04)
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Fine-tuning fluids with bioimpedance may save lives on PD
A study of 529 PD patients tracked between 2008 and 2012 using a Body Composition Monitor found that overhydration (OH) is lethal. Patients in the top 33% for OH had an 83% higher risk of death. Body mass index (BMI) was not a factor.
Read the abstract » | (added 2014-08-04)
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Fewer hospital days with home HD
Is home HD really better—or does it just look better because younger, healthier people choose to do it? Researchers looked at hospital days of 25 people on home HD vs. 25 standard in-center HD patients who were healthy enough to be on the transplant list. Across the group, home HD patients spent 71 days in the hospital, and standard in-center HD patients spent 85 (P<0.005). The authors concluded that this study “confirms the superiority of the HHD treatment option in improving patient outcomes.
Read the abstract » | (added 2014-07-07)
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All about icodextrin – in one place
A new review explains why and how to use icodextrin appropriately and avoid adverse events. Learn about the hemodynamic, metabolic, and idiopathic effects of this glucose-sparing PD fluid so you can prescribe it with confidence.
Read the abstract » | (added 2014-07-07)
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X-rays predict functional PD catheter problems in advance
The PD catheter angle (inclination) as seen on X-ray was able to predict functional problems during 36 months of follow up, in a new study of 110 consecutive patients getting a first PD catheter. Only inclined catheters had to be surgically corrected.
Read the abstract » | (added 2014-07-07)
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First-year outcomes of incident US PD patients
Among 1,677 incident PD patients from Fresenius, 367 switched to HD within the first 90 days. Of those who continued with PD, first-year mortality was 10 per 100 patient-years, with 42 episodes of peritonitis and 128 hospitalizations per 100 patient-years. About 2/3 of the hospitalizations occurred in the first 6 months of PD therapy. Of those who switched to HD, 81.4% began treatment with a central venous catheter—and 78.3% still had one 90 days later.
Read the abstract » | (added 2014-07-07)
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Home HD: Flexibility, control, and independence
In-depth interviews with 24 home HD patients in New Zealand found that dialysis was disruptive in terms of the body and the time it takes—but also a positive experience on many levels, especially the way people relate to others.
Read the abstract » | (added 2014-07-07)
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Inflammation in PD? Look to the gums!
Researchers looked at gum disease in 68 people who were doing CAPD, and rated it as healthy, slight to moderate, and severe. Patients whose C-reactive protein levels (a marker of inflammation) were higher had worse gum disease and had been on PD longer. Those with heart disease and diabetes also had worse gum disease. The authors suggest that all people who use PD should have their gums checked.
Read the abstract » | (added 2014-06-05)
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Can short daily HD treat hypertension on dialysis?
Ah, cherish the rare RCT in dialysis. In this study, a group of standard HD patients with high blood pressure were switched to short daily HD to see if it could reduce their BP (and if so, how). Bioimpedance was used to check extracellular fluid volume (ECFV). Inflammation and oxidative stress were also measured. After 3 months, BPs were similar between the two groups—but the short daily HD patients needed significantly fewer BP medications. The reason for the difference is still a mystery.
Read the abstract » | (added 2014-06-05)
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