Journal Watch

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  • Virtual Nephrologist Mentoring for Home Therapies

    A “hub and spoke” model for virtual home mentorship may help overcome some of the physician barriers to home therapies, suggest some of the top Canadian home dialysis nephrologists, who also review the literature.

    Read the abstract » | (added 2021-03-09)

    Tags: Home Dialysis, Peritoneal Dialysis, Pd

  • New PD Fluid Tested in Italy

    Most PD fluid is glucose-based, unphysiologic, and can cause fibrosis and long-term damage to the peritoneum—but that may be changing. A new PD fluid replaces the glucose with L-carnitine and/or xylitol. After 4 weeks on the new fluid, 10 CAPD patients had good tolerance and no adverse safety events. More research will be needed, but this looks promising.

    Read the abstract » | (added 2021-03-09)

    Tags: PD Fluid, Carnitine

  • Outcomes and Costs of Assisted PD

    As many as half of those who could use PD need assistance to do so, and many countries outside the U.S. offer this. A narrative review found no differences in quality of life, hospitalization, or mortality between PD and in-center HD patients after adjusting for age and frailty. Nurse assistance may result in better technique survival than family assistance. Assisted PD was still significantly less costly than in-center HD in Canada and Western Europe.

    Read the abstract » | (added 2021-03-09)

    Tags: Assisted Peritoneal Dialysis, Barriers, Cost, Hemodialysis, Peritoneal Dialysis, Pd

  • Functional Iron Deficiency and Survival on PD

    A 10-year retrospective look at survival examined records from 1,173 PD patients who had normal iron levels, absolute iron deficiency, functional iron deficiency (FID), or high iron levels. Among the group, 77.5% had iron deficiency, and FID, in particular, was linked with an increased risk of all-cause—but not cardiovascular—mortality.

    Read the abstract » | (added 2021-03-09)

    Tags: Mortality, Peritoneal Dialysis, PD

  • Shared decision-making (SDM) About Modality: PD vs. HD Experiences

    A cross-sectional survey of 300 dialysis patients (82 on PD and 218 on HD) revealed that those on PD were significantly more likely to report having received an SDM conversation than those on HD. The authors conclude that SDM should take place in the early stages of CKD.

    Read the abstract » | (added 2021-03-09)

    Tags: Hemodialysis, Peritoneal Dialysis, PD

  • Missed Opportunities to Help Patients to Home Dialysis

    Even strong home dialysis programs do not always successfully get everyone who is interested in a home therapy to go home. In British Columbia, of the 1,845 patients who started dialysis between 2015 and 2017, 34% started on their preferred home therapy—while 8.9% did not, and 8.4% had remained undecided and started in-center. A significant factor was that those who chose and started a home treatment had more home therapy-specific (vs. “general modality orientation”) education

    Read the abstract » | (added 2021-03-09)

    Tags: Home Hemodialysis, Peritoneal Dialysis, Pd

  • Low PTH Levels a Risk Factor for Peritonitis on PD

    Two hundred seventy incident PD patients over a 7-year period were divided into a low-PTH (<150 pg/mL), middle-PTH (150-300 pg/mL), and high-PTH (>300 pg/mL) groups. After follow up for 16-49 months, patients with low PTH levels had a 64% higher risk of peritonitis.

    Read the abstract » | (added 2021-02-09)

    Tags: Peritoneal Dialysis, Pd, Parathyroid Hormone

  • A Better Nutritional Marker for CAPD Adequacy

    Move over prealbumin, albumin, and ferritin—normalized protein catabolic rate (nPCR) was the only marker that correlated with CAPD adequacy in a study of 266 patients divided into an adequate (total weekly Kt/V urea >1.70) and an inadequate PD group (<1.70). Male gender, higher weight, and residual GFR <2.43 mL/min/1.73m2 were risk factors for inadequate CAPD.

    Read the abstract » | (added 2021-02-09)

    Tags: Peritoneal Dialysis, Pd

  • Choosing Home Dialysis Does Not Mean Getting It

    A retrospective, single-center study that followed 167 patients referred for CKD education in 2019 through 2020 found that just 23% chose standard in-center HD—74% chose home, and the remaining 3% were undecided. But, with 90% of patients living in New York City with limited space, and a clinic requirement that a trained care partner be present for all treatments, 56% of the in-center HD patients had chosen a home treatment. (Hint: Stop requiring a care partner!)

    Read the abstract » | (added 2021-02-09)

    Tags: Home Dialysis, Home Hemodialysis, Peritoneal Dialysis, Pd

  • The Better to See You With, My Dear

    Would you rather have a surgeon feel where a PD catheter should go—or see what s/he is doing? Researchers tried an optical puncture system on 25 patients between 2018 and 2019, while 40 patients had routine placements. Even though more of the optical patients had prior abdominal surgeries, catheter placement took less time and had a similar rate of complications.

    Read the abstract » | (added 2021-02-09)

    Tags: Peritoneal Dialysis, Catheter, Optical Puncture System