Peritoneal dialysis

Worldwide, among those receiving dialysis for end-stage kidney failure, 11% receivetreatment with peritoneal dialysis (PD) with the majority receiving facility-basedhemodialysis (HD). Recent initiatives have led to PD utilization increases in theUnited States. Quantifying how long patients remain on PD (i.e., time on therapy) isimportant for patients and providers. Here we have described: (1) time on PD in thecontext of outcomes of hemodialysis transfer (HDT), death, and kidneytransplantation, and (2) patient-level and practice pattern determinants of theseoutcomes, in 7 countries.

Patients with chronic or terminal illnesses may find it easier to manage their conditions if they have a strong sense of their spiritual well-being (SWB) or their perception of the meaning and purpose of life. For a study, researchers evaluated SWB in patients with PD as well as its associations with patient features and outcomes as reported by patients (PRO).

In summary, in this real-world multi-centric parallel analysis of nationally representative cohorts of incident PD patients in Brazil and the United States, we found that individuals who are more fatigued within 90 days of PD initiation had higher risks for all-cause mortality that was independent of key confounders.

Despite the difference in features provided between the 2 cyclers, patient overall satisfaction rates were high irrespective of the PD cycler. The HomeChoice Pro and AMIA cycler patients had a similar number of PD training days, PD-related telephone/office encounters, and PD-related emergency room visits/hospitalizations.

Chronic kidney disease (CKD) affects millions of people around the world. Diet is crucial for the best prognosis. At Mount Sinai Hospital in New York, CKD specialist Jaime Uribarri is planning to investigate the impact of a renal diet with low-phosphorous whey protein. If all goes well, kidney patients will gain a new dietary tool to help them live a satisfactory life.

At NxStage, we’ve seen first-hand how patients have enjoyed improved health and a better quality of life through more frequent home dialysis whether HHD or PD. But don’t take our word for it. Many studies have shown that the benefits of home dialysis go far beyond convenience.

The utmost important and serious complication of peritoneal dialysis is infection around the access area. Which usually exists in skin or inside the abdominal area. Hernia is an another issue created by this procedure, weakness in the abdominal muscles.

By offering policy suggestions that include improving data collection to better understand costs in peritoneal dialysis, and sharing potential savings among all stakeholders, to incentivize a transition to peritoneal dialysis.

The transition from PD to HD is characterized by high rates of acute-care encounters and health-care expenditures. Quality improvement efforts should be aimed at improving transitions and encouraging both home HD and kidney transplantation after PD discontinuation.

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 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.

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.

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.

An important reason for the low PD prevalence is patient dropouts, that is, transfer to HD. The reasons for dropouts are multifactorial, that is, modality related, system related, and patient related. These include episodes of peritonitis, catheter-related problems, ultrafiltration failure, patient fatigue, and provider comfort. This review discusses the various factors that contribute to PD dropout and the strategies to prevent it.

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.

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.

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.

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.

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, 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.

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.