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Peritoneal Dialysis International :... May 2024
Topics: Humans; Peritoneal Dialysis; Kidney Failure, Chronic
PubMed: 38775049
DOI: 10.1177/08968608241251923 -
The American Journal of the Medical... Sep 2014Peritoneal dialysis (PD) continues to be underutilized in the United States, even though it is less expensive, provides better quality of life and has better outcomes... (Review)
Review
Peritoneal dialysis (PD) continues to be underutilized in the United States, even though it is less expensive, provides better quality of life and has better outcomes compared with hemodialysis. The reasons for low utilization of PD are influenced by complex psychosocial and economic factors, lack of physician training, physician bias and inadequate pre-end-stage renal disease care and education to the patients. Providing quality pre-end-stage renal disease education to patients and families and improving education and training of physician in PD, so that they become comfortable with the therapy, are of paramount importance to increase PD growth. Minimizing episodes of PD-related infections and noninfectious complications, preserving peritoneal membrane using more biocompatible solutions and drugs, such as angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, and careful management of volume status can reduce the loss of PD patients to hemodialysis. Timely surgical interventions can prevent the malfunction and loss of PD catheters. Consolidating smaller PD facilities in a given geographical area into a single large PD center can further improve PD outcomes and PD growth. Finally, with the introduction of bundled payment for dialysis services, PD may emerge as a cost-effective therapy and rekindle interest in the dialysis community to consider PD as a better renal replacement therapy option.
Topics: Clinical Competence; Cost-Benefit Analysis; Humans; Kidney Failure, Chronic; Perception; Peritoneal Dialysis; Renal Dialysis
PubMed: 24875660
DOI: 10.1097/MAJ.0000000000000283 -
Peritoneal Dialysis International :... Dec 2018The series of papers that are included in this China Supplement to chart peritoneal dialysis (PD) research over the last several years in that country, provide detailed... (Review)
Review
The series of papers that are included in this China Supplement to chart peritoneal dialysis (PD) research over the last several years in that country, provide detailed analysis of a large de-identified dataset from the Baxter Patient Support Program, and include 2 papers that describe clinical experiences relevant to the local context. These studies present a fascinating insight into the practice of PD in China, adding considerably to the sum of worldwide PD experience. China presents important opportunities for clinical research to answer key questions relevant to our therapy.
Topics: China; Female; Humans; Kidney Failure, Chronic; Male; Outcome Assessment, Health Care; Peritoneal Dialysis; Peritoneal Dialysis, Continuous Ambulatory; Risk Assessment; Survival Rate
PubMed: 30530596
DOI: 10.3747/pdi.2018.00224 -
American Journal of Kidney Diseases :... Aug 2018
Topics: Humans; Kidney Transplantation; Paintings; Peritoneal Dialysis; Renal Insufficiency
PubMed: 29903657
DOI: 10.1053/j.ajkd.2018.05.003 -
The American Journal of the Medical... Jan 2021
Topics: Health Services Accessibility; Humans; Peritoneal Dialysis; Social Class; Vulnerable Populations
PubMed: 33422190
DOI: 10.1016/j.amjms.2020.10.024 -
Peritoneal Dialysis International :... Jan 2021
Topics: Acute Kidney Injury; Adult; Humans; Peritoneal Dialysis
PubMed: 33499780
DOI: 10.1177/0896860820983676 -
Blood Purification 2023Unplanned peritoneal dialysis (PD) is an important option for chronic kidney disease (CKD) patients requiring kidney replacement therapy urgently as it offers the...
INTRODUCTION
Unplanned peritoneal dialysis (PD) is an important option for chronic kidney disease (CKD) patients requiring kidney replacement therapy urgently as it offers the convenience of home-based therapy. The objective of this study was to assess the Brazilian urgent-start PD program in three different dialysis centers where there is shortage of hemodialysis (HD) beds.
METHODS
This prospective, multicentric cohort study included incident patients with stage 5 CKD and no permanent vascular access established who started urgent PD between July 2014 and July 2020 in three different hospitals. Urgent-start PD was defined as initiation of treatment up to 72 h after catheter placement. Patients were followed up from catheter insertion and assessed according to mechanical and infectious complications related to PD, patients, and technique survival.
RESULTS
Over 6 years, 370 patients were included in all three study centers. Mean patient age was 57.8 ± 16.32 years. Diabetic kidney disease was the main underlying condition (35.1%) and uremia was the main cause for dialysis indication (81.1%). Concerning complications related to PD, 24.3% had mechanical complications, 27.3% had peritonitis, 28.01% had technique failure, and 17.8% died. On logistic regression, hospitalization (p = 0.003) and exit site infection (p = 0.002) were identified as predictors of peritonitis, while mechanical complications (p = 0.004) and peritonitis (p < 0.001) were identified as predictors of technique failure and switching to HD. Age (p < 0.001), hospitalization (p = 0.012), and bacteremia (p = 0.021) were observed to predict death. The number of patients on PD increased at least 140% in all three participating centers.
CONCLUSION
PD is a feasible option for patients starting dialysis in an unplanned manner and may be a useful tool for reducing shortage of HD beds.
Topics: Humans; Adult; Middle Aged; Aged; Renal Dialysis; Cohort Studies; Prospective Studies; Brazil; Peritoneal Dialysis; Kidney Failure, Chronic; Renal Insufficiency, Chronic; Peritonitis
PubMed: 37290412
DOI: 10.1159/000529133 -
Kidney360 May 2022
Topics: Dialysis Solutions; Icodextrin; Peritoneal Dialysis
PubMed: 36128486
DOI: 10.34067/KID.0001902022 -
The Journal of Vascular Access 2015In peritoneal dialysis (PD), a well-functioning catheter is of great importance, because a dysfunctional catheter may be associated with incidence of peritonitis,... (Review)
Review
In peritoneal dialysis (PD), a well-functioning catheter is of great importance, because a dysfunctional catheter may be associated with incidence of peritonitis, efficiency of dialysis, and to the overall quality of treatment, representing one of the main barriers to optimal use of PD. When considering the relationship between PD catheter type and outcomes, we should keep in mind the different types of available PD catheters, those that are most commonly used in clinical practice, and the available head-to-head comparisons in the literature. The main differences in PD catheter design include the number of cuffs, the shape of subcutaneous tract (straight vs. swan neck), and the shape of intraperitoneal tract (straight vs. coiled). The availability of the best catheter design and materials, along with a skillful management of PD access, may have the greatest impact on long-term patient outcome on PD. It is now established that the use of straight catheters may improve outcomes and technique survival, but further advances in PD catheter technology can potentially improve technique survival. The self-locating PD catheter is a well established device that has not been fully studied and it may represent, based on the available observational evidence and on the clinical experience, an already existing technological advance deserving further studies.
Topics: Catheters, Indwelling; Equipment Design; Humans; Peritoneal Dialysis; Peritonitis; Risk Factors; Treatment Outcome
PubMed: 25751555
DOI: 10.5301/jva.5000369 -
Peritoneal Dialysis International :... Nov 2021
Topics: Humans; Kidney Failure, Chronic; Peritoneal Dialysis; Peritonitis
PubMed: 34743614
DOI: 10.1177/08968608211054374