Peritoneal dialysis

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.

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.

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.

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.

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.

Dialysis removes waste and extra fluid from the blood, just as your kidneys would if they were fully functioning. The two main types of dialysis, hemodialysis and peritoneal dialysis, filter your blood via two different filtering processes. Although dialysis, often done at least three times a week, can be time-consuming, you can still lead a happy, healthy life while on treatment. Learn more about the different types of dialysis below, then work with your doctor to decide which type will work best for you.

The platform mDoc Homecare will come as an application for patients and a desktop version for doctors. The mobile app for patients provides medical questionnaires before a visit, regular messenger consultation, reservation, and emergency consultation services. The desktop version for doctors will offer efficient patient management services. Also, the company is preparing patient list management and patient management linked to electronic medical record (EMR) systems in hospitals.

Peritoneal dialysis (PD) is a cost-effective, home-based therapy for patients with end-stage renal disease achieving similar outcome as compared to hemodialysis. Still, a minority of patients only receive PD. To a significant extend, this discrepancy is explained by major limitations regarding PD efficiency and sustainability. Due to highly unphysiological composition of PD fluids, the peritoneal membrane undergoes rapid morphological and long-term functional alterations, which limit the treatment and contribute to adverse patient outcome. This review is focused on the peritoneal membrane ultrastructure and its transformation in patients with kidney disease and chronic PD, underlying molecular mechanisms, and potential systemic sequelae.

Peritoneal dialysis (PD) is one of the options available for treating end-stage kidney disease, the last stage of chronic kidney disease in which the organs no longer work enough for a patient to survive without dialysis or a transplant. In the option most people know, haemodialysis, patients visit a dialysis centre thrice weekly to use a machine that filters excess fluid and solutes from their bloodstream.

Progressive structural changes in the peritoneal membrane occur over the course of treatment in peritoneal dialysis (PD), resulting in an increase in cytokines such as CCL2 and structural changes in peritoneal membrane triggering an increase in CA-125 in dialysate, which reflects a probable local inflammatory process, with possible loss of mesothelial cells. Thus, the current study aimed to evaluate the association between plasma and CCL2 and CA-125 dialysate levels in patients undergoing PD.

In normal renal physiology, the kidneys remove waste and excess water from the body and release hormones such as renin (which regulates blood pressure), erythropoietin (which stimulates red blood cell production), and vitamin D (which promotes normal bone structure). However, in kidney failure or End Stage Renal Disease (ESRD), renal function becomes compromised and waste products and toxic materials start to accumulate rather than get excreted. This may cause permanent irreversible damage to the body’s cells, tissues, and organs. In End Stage Renal Disease, the kidneys function at less than 20% of their required capacity, and renal replacement therapy in the form of haemodialysis, peritoneal dialysis or kidney transplantation becomes a requirement.

Among patients receiving peritoneal dialysis, inadequate fluid management is associated with a higher risk of cardiovascular morbidity and mortality. There may also be an association between inadequate fluid management and shortened peritoneal technique survival. Jennifer E. Flythe, MD, MPH, and colleagues conducted an analysis designed to examine the associations between fluid-related clinical factors and peritoneal dialysis technique failure within 1 year of treatment initiation.

Traditional hemodialysis uses a machine to take over the kidneys’ job, taking blood out of the body, filtering it and diluting out the toxins against large amounts of fluids that approximate blood plasma. This process is very safe on the heart and is effective at removing blood toxins. Only a small amount of blood is outside the body at any given time.

Worldwide, heart failure remains a significant health problem despite available therapies; many patients reach advanced stages of heart failure, complicated by diuretic resistance, kidney dysfunction, and refractory congestion, all prevalent in advanced disease. Options for treatment of fluid overload include hemodialysis or peritoneal dialysis.

When facing dialysis, there are different types of dialysis access to consider. Peritoneal dialysis (PD) uses only one type of access—a peritoneal dialysis catheter. Hemodialysis (HD) uses an arteriovenous (AV) fistula or graft—or, if medically necessary, a hemodialysis catheter. Ideally, you want the access type that gives you the best quality of dialysis treatment and the lowest risk of infection. Talk to your doctor to determine which type of access is right for you.

The fear of contracting the virus was enough to keep many from venturing out for medical care, including those already on dialysis and those set to get the treatment for the first time. Exactly how long patients can go without dialysis depends on a number of factors, but doctors generally begin to worry if they miss two of their thrice-weekly sessions.

This study showed a significant increase in hospitalization rates after the COVID-19 pandemic period and telemedicine implementation, mainly due to PD-related infectious causes. Strategies to improve distance monitoring assistance are needed for the PD population.

Our findings suggest frequent use of an RTM application associates with less hospital admissions, shorter hospital length of stay, and lower technique failure rates. Adoption of RTM applications may have the potential to improve timely identification/intervention of complications.

It has been noticed for years that ultrafiltration (UF) is important for survival in peritoneal dialysis. On the other hand, precise and convenient UF measurement suitable for patient daily practice is not as straight forward as it is to measure UF in the lab. Both overfill and flush before fill used to be source of measurement error for clinical practice. However, controversy finding around UF in peritoneal dialysis still exists in some situation. The current study was to understand the difference between clinical measured UF and real UF. The effect of evaporation and specific gravity in clinical UF measurement were tested in the study.