The incidence of pain and its association with quality of life in patients with peritoneal dialysis May 9, 2022, 9:14 a.m.
The incidence of pain in PD patients was 33.1%. Older age and higher intact parathyroid hormone level were independent risk factors for pain. Pain was independently associated with depressive symptoms, sleep quality and quality of life in PD patients.
Quality of life in peritoneal dialysis patients: Decline over time and association with clinical outcomes May 9, 2022, 9:14 a.m.
Quality of life declines in patients on PD over time. Certain aspects of QoL are especially poor in Asian and male patients. This study suggests that further research is necessary to determine the effects of interventions directed at enhancing emotional and social support.
Bioimpedance spectroscopy: Is a picture worth a thousand words? May 2, 2022, 7:42 a.m.
Volume status can be difficult to assess in dialysis patients. Peripheral edema, elevated venous pressure, lung crackles, and hypertension are taught as signs of fluid overload, but sensitivity and specificity are poor. Bioimpedance technology has evolved from early single frequency to multifrequency machines which apply spectroscopic analysis (BIS), modeling data to physics-based mixture theory. Bioimpedance plots can aid the evaluation of hydration status and body composition. The challenge remains how to use this information to manage dialysis populations, particularly as interventions to improve over hydration, sarcopenia, and adiposity are not without side effects. It is therefore of no surprise that validation studies for BIS use in peritoneal dialysis patients are limited, and results from clinical trials are inconsistent and conflicting. Despite these limitations, BIS has clinical utility with potential to accurately evaluate small changes in body tissue components. This article explains the information a BIS plot ("picture") can provide and how it can contribute to the overall clinical assessment of a patient. However, it remains the role of the clinician to integrate information and devise treatment strategies to optimize competing patient risks, fluid and nutrition status, effects of high glucose PD fluids on membrane function, and quality of life issues.
What is BIS? May 2, 2022, 7:40 a.m.
Bioimpedance spectroscopy (BIS) is the only noninvasive, low-cost technology that can accurately measure a patient’s total body water, extracellular and intracellular fluid volumes in a clinical setting. This detailed data can help healthcare professionals with early detection, assessment and interventions for chronic conditions.
The best part about Peritoneal Dialysis is that it is continuous April 18, 2022, 7:09 a.m.
PD is a continuous therapy. It is happening all the time. The fluid in the peritoneal cavity is filtering out excess water from the blood continuously.
Continuous ambulatory peritoneal dialysis. Patient and method survival rate, peritonitis incidence and dialysis efficacy over 10 years April 11, 2022, 12:59 p.m.
From 1979 to 1989, continuous ambulatory peritoneal dialysis (CAPD) was undertaken for terminal renal failure in 104 patients (56 women and 48 men; average age 54 +/- 15.3 years at the onset of dialysis), for a total observation period of 175 patients years. Survival rate for patients and methods and dialysis effectiveness were analysed retrospectively, the incidence of peritonitis prospectively, 40 patients were aged 60 years and over.
The Underrated Role of Ultrasound in Peritoneal Dialysis April 4, 2022, 7:39 a.m.
Ultrasound is very effective in performing procedures and assessment of complications in peritoneal dialysis. The ultrasound examination can be applied for preoperative assessment, during the peritoneal catheter placement, for the detection and monitoring of infection, as well as for the evaluation of the catheter malfunction. Despite being not only a cost- and time-saving technique but also a bedside procedure, ultrasonography remains an underrated clinical tool in the field of peritoneal dialysis. This publication wants to explain and reinforce the clinical utility of US in PD and to expand the diagnostic equipment for the clinician.
Laparoscopic versus open-surgery catheter placement in peritoneal dialysis patients March 24, 2022, 11:33 a.m.
In conclusion, the laparoscopic PDC placement procedure was superior to open surgery in regards to catheter malfunction. Additionally, the choice of treatment procedure should put in consideration factors such as cost and comfortability of the patient.
Top 10 Companies In Hemodialysis and Peritoneal Dialysis Market March 24, 2022, 11:32 a.m.
The growth of hemodialysis and peritoneal dialysis market is primarily driven by factors such as the growing prevalence of kidney disorders, diabetes, and hypertension; increasing number of dialysis centers; initiatives for chronic kidney care; and shortage& side-effects of kidney transplants. However, reimbursement concerns in emerging markets and stringent regulatory policies for the approval and manufacturing of dialysis products hinders the growth of this market to a certain extent. Moreover, technological advancements provide significant opportunities for players operating in this market.
Percutaneous versus laparoscopic techniques in PD surgery March 24, 2022, 11:31 a.m.
As dialysis modalities go, peritoneal dialysis (PD) is currently among the more popular choices in treating kidney disease patients. For many physicians, its perceived benefits—a decreased burden on the patient and their day-to-day living arguably being the most important of these—place it somewhere between the ‘gold standard’ of transplantation and the increasingly maligned option of in-centre haemodialysis within therapy algorithms.
Plant-based diets to manage the risks and complications of chronic kidney disease March 24, 2022, 11:26 a.m.
Current evidence suggests that promoting the adoption of plant-based diets has few risks but potential benefits for the primary prevention of CKD, as well as for delaying progression in patients with CKD G3–5. These diets might also help to manage and prevent some of the symptoms and metabolic complications of CKD. We suggest that restriction of plant foods as a strategy to prevent hyperkalaemia or undernutrition should be individualized to avoid depriving patients with CKD of these potential beneficial effects of plant-based diets. However, research is needed to address knowledge gaps, particularly regarding the relevance and extent of diet-induced hyperkalaemia in patients undergoing dialysis.
Plant-Based Diets and Peritoneal Dialysis: A Review March 21, 2022, 2:36 p.m.
Whole food plant-based diets are gaining popularity as a preventative and therapeutic modality for numerous chronic health conditions, including chronic kidney disease, but their role and safety in end-stage kidney disease patients on peritoneal dialysis (PD) is unclear. Given the general public’s increased interest in this dietary pattern, it is likely that clinicians will encounter individuals on PD who are either consuming, considering, or interested in learning more about a diet with more plants. This review explores how increasing plant consumption might affect those on PD, encompassing potential benefits, including some specific to the PD population, and potential concerns.
Fresenius Medical Care uses virtual reality technology to train patients for home dialysis March 14, 2022, 7:28 a.m.
Fresenius Medical Care, the world’s leading provider of products and services for individuals with renal diseases, has started using virtual reality (VR) technology to train patients to perform peritoneal dialysis. The stay•safe MyTraining VR is being offered first in Germany and will be extended to other countries in the company’s Europe, Middle East and Africa region later this year.
Imaging of Peritoneal Dialysis Complications in Children March 7, 2022, 5:31 p.m.
Familiarity with the clinical presentations and imaging appearances of peritoneal dialysis–related complications in children can facilitate accurate diagnosis and proper management of these complications.
Why Peritoneal Dialysis is Underutilized in the United States: A Review of Inequities Feb. 28, 2022, 9:35 a.m.
Given a choice, most patients with end-stage renal disease prefer home dialysis over in-center hemodialysis (HD). Peritoneal dialysis (PD) is a home dialysis method and offers benefits such as absence of central venous access and therefore preservation of veins, low cost, and decreased time per dialysis session, as well as convenience. Survival rate for patients on PD has increased to levels comparable to in-center HD. Despite endorsement by leaders in the medical field, professional societies, and those in government, PD has reached only 11% adoption among incident patients according to the 2019 United States Renal Data System Annual Data Report.
Socioeconomic Factors and Racial and Ethnic Differences in the Initiation of Home Dialysis Feb. 28, 2022, 9:35 a.m.
Although the United States has experienced a recent growth in the use of home dialysis, the incidence remains low: only 10% of patients who initiated dialysis started with peritoneal dialysis (PD) or home hemodialysis (HHD) in 2016. The difference is even more striking among black and Hispanic patients, who make up 41% of the incident dialysis population but only 33% of those starting on home dialysis.1 Although these disparities have been well documented, it is less clear what factors might be driving the differences.
Differences in hospitalisation between peritoneal dialysis and haemodialysis patients Feb. 14, 2022, 3:11 p.m.
PD was associated with higher hospitalisation rate, higher risk for first hospitalisation, and higher number of hospitalisations compared to HD. Since the PD hospitalisations were mainly caused by peritonitis, more attention to infection prevention is necessary for reducing the number of hospitalisations in the future.
Solo/Independent Home Dialysis Feb. 12, 2022, 9:43 a.m.
Solo home dialysis, sometimes referred to as self- or independent dialysis, is dialysis therapy administered at home, by yourself, without any required assistance. Kidney disease patients have two therapy options for solo treatment–more frequent home hemodialysis (HHD) and peritoneal dialysis (PD), both of which can offer many clinical and lifestyle benefits compared to traditional three-times weekly in-center hemodialysis (ICHD)1. Since PD is almost always done independently at home, here we will focus more on solo HHD.
Kidney Transplant Explained Feb. 12, 2022, 9:42 a.m.
For most people whose kidneys have failed, the best treatment is a kidney transplant. While dialysis – whether haemodialysis or peritoneal dialysis – is a fantastic treatment that allows a person with kidney failure to live with fairly satisfactory health, it still has certain limitations. One is in terms of long-term health complications. While dialysis does a good job at removing waste products and excess fluids from our blood, it is not a perfect replacement for a functioning kidney. Thus, those undergoing this procedure are still vulnerable to chronic complications such as anaemia, renal bone disease, heart disease and stroke, among others.
Urinary tract infections in patients with renal insufficiency and dialysis - epidemiology, pathogenesis, clinical symptoms, diagnosis and treatment Feb. 12, 2022, 9:37 a.m.
Urological interventions, catheterization, as well as repeated courses of antibiotics contribute to an increased challenge of antimicrobial resistance. The diagnosis of UTI in CKD is based on standard clinical and laboratory criteria. Pyuria (≥10 leucocytes/µl) is more often observed in patients with oligoanuria and low bacterial colony counts. The treatment strategies for this population are based on the same principles as in patients with normal renal function. However, drugs cleared by the kidney or by dialysis membranes need dose adjustment. Antimicrobials with potential systemic toxicity and nephrotoxicity should be administered with caution.