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Hemodialysis versus peritoneal dialysis

Anja Gäckler, Hana Rohn, Ton Lisman, Tamas Benkö, Oliver Witzke, Andreas Kribben, Fuat H Saner
An increased bleeding risk is reported for patients with end-stage renal disease. This study aims to analyze, whether bleeding risk can be assessed by global tests of hemostasis. Standard laboratory tests and an extended evaluation of hemostasis by rotational thromboelastometry, platelet function analyzer (PFA) and multiple electrode aggregometry as well as thrombin generation assays and measurement of fibrinolytic potential were performed in 20 patients on hemodialysis, 10 patients on peritoneal dialysis, 10 patients with chronic kidney disease stage G5 (CKD5) and in 10 healthy controls (HC)...
2019: PloS One
Boonphiphop Boonpheng, Charat Thongprayoon, Michael A Mao, Karn Wijarnpreecha, Tarun Bathini, Wisit Kaewput, Patompong Ungprasert, Wisit Cheungpasitporn
BACKGROUND: Bone and mineral metabolism disorders are common among end-stage renal disease (ESRD) patients, which could lead to hip fracture. It is unclear whether the hip fracture risk is different among patients on hemodialysis (HD) versus peritoneal dialysis (PD). This meta-analysis was conducted to evaluate the hip fracture risk in ESRD patients on HD, when compared to PD. METHODS: A literature review was conducted in EMBASE, MEDLINE, and Cochrane databases through January 31, 2018 to identify studies that appraised the rate or risk of hip fracture among patients on HD, when compared to PD...
January 30, 2019: Journal of Evidence-based Medicine
Andrea K Viecelli, Charmaine E Lok
Choosing the optimal hemodialysis vascular access for the elderly patient is best achieved by a patient-centered coordinated multidisciplinary team approach that aligns the patient's end-stage kidney disease Life-Plan, i.e., the individual treatment approach (supportive care, time-limited or long-term kidney replacement therapy, or combination thereof) and selection of dialysis modality (peritoneal dialysis versus hemodialysis) with the most suitable dialysis access. Finding the right balance between the patient's preferences, the likelihood of access function and survival, and potential complications in the context of available resources and limited patient survival can be extremely challenging...
January 2019: Kidney International
Hany M El Hennawy, Ahmed Al Hashemy, Nafaa Al Harbi, Wael T Habhab, Ahmed E Fahmy
Outcome of pediatric kidney transplantation (KT) has improved over the last several decades. We retrospectively reviewed the outcomes pediatric KT in King Faisal Specialist Hospital and Research Center-Jeddah, Saudi Arabia. Between May 2013 and November 2016, we performed renal transplantation in 47 children, 30 (64%) males, and 17 (36%) females. All patients received antibody induction with basiliximab or antithymocyte globulin along with triple immunosuppressive therapy with tacrolimus, mycophenolate mofetil and steroids...
November 2018: Saudi Journal of Kidney Diseases and Transplantation
Kinga Musiał, Danuta Zwolińska
CONTEXT: Chronic kidney disease (CKD) is characterized by immunocompetent cell migration and inflammation. Monocyte chemoattractant protein (MCP)-1 and macrophage colony-stimulating factor (MCSF) stimulate monocyte migration and transition into macrophages, with subsequent release of neopterin. OBJECTIVE: The aim of the study was to analyze these parameters in children with various stages of CKD. MATERIAL AND METHODS: The study group consisted of 41 CKD children, 19 patients on hemodialysis (HD), 22 children on automated peritoneal dialysis (APD), and 23 controls...
December 5, 2018: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
Stephen Stonelake, Jyoti Baharani, Mark Thomas, Roger Adkins, Lee Hollingsworth, Teun Wilmink
BACKGROUND: The weighted catheter has shown promising results in retrospective and randomized studies. We examined its usefulness in patients with previous failed non-weighted peritoneal dialysis (PD) catheters or previous abdominal surgery. METHODS: The insertion, start, end, and removal dates were recorded for all-type catheter insertions from 2011 to 2016. Primary and secondary failure rates were recorded, defined as failure to ever establish flow (primary) or failure after a period of successful PD (secondary)...
November 25, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Zbylut J Twardowski, Madhukar Misra
Hemodialysis for chronic renal failure was introduced and developed in Seattle, WA, in the 1960s. Using Kiil dialyzers, weekly dialysis time and frequency were established to be about 30 hours on 3 time weekly dialysis. This dialysis time and frequency was associated with 10% yearly mortality in the United States in 1970s. Later in 1970s, newer and more efficient dialyzers were developed and it was felt that dialysis time could be shortened. An additional incentive to shorten dialysis was felt to be lower cost and higher convenience...
November 20, 2018: Hemodialysis International
Virginia Wang, Cynthia J Coffman, Linda L Sanders, Shoou-Yih D Lee, Richard A Hirth, Matthew L Maciejewski
BACKGROUND AND OBJECTIVES: Peritoneal dialysis is a self-administered, home-based treatment for ESKD associated with equivalent mortality, higher quality of life, and lower costs compared with hemodialysis. In 2011, Medicare implemented a comprehensive prospective payment system that makes a single payment for all dialysis, medication, and ancillary services. We examined whether the prospective payment system increased dialysis facility provision of peritoneal dialysis services and whether changes in peritoneal dialysis provision were more common among dialysis facilities that are chain affiliated, located in nonurban areas, and in regions with high dialysis market competition...
November 19, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Fernando Beltramo, Joseph DiCarlo, Joshua B Gruber, Thom Taylor, Balagangadhar R Totapally
OBJECTIVES: The objective of this study is to describe the relative frequency of use of continuous renal replacement therapy, intermittent hemodialysis, and peritoneal dialysis and to analyze characteristics and outcomes of critically ill children receiving renal replacement therapies admitted to PICUs that participate in the Virtual PICU (VPS LLC, Los Angeles, CA) registry. DESIGN: Retrospective, database analysis. SETTING: PICUs that participate in the Virtual PICU (VPS LLC) registry...
January 2019: Pediatric Critical Care Medicine
Xuemei Li, Hong Xu, Nan Chen, Zhaohui Ni, Menghua Chen, Limeng Chen, Jie Dong, Wei Fang, Yusheng Yu, Xiao Yang, Jianghua Chen, Xueqing Yu, Qiang Yao, James A Sloand, Mark R Marshall
BACKGROUND: There is an emerging practice pattern of automated peritoneal dialysis (APD) in China. We report on outcomes compared to continuous ambulatory peritoneal dialysis (CAPD) in a Chinese cohort. METHODS: Data were sourced from the Baxter Healthcare (China) Investment Co. Ltd Patient Support Program database, comprising an inception cohort commencing PD between 1 January 2005 and 13 August 2015. We used time-dependent cause-specific Cox proportional hazards and Fine-Gray competing risks (kidney transplantation, change to hemodialysis) models to estimate relative mortality risk between APD and CAPD...
December 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Dugan W Maddux, Len A Usvyat, Thomas Blanchard, Yue Jiao, Peter Kotanko, Frank M van der Sande, Jeroen P Kooman, Franklin W Maddux
BACKGROUND: Peritoneal dialysis (PD) starters generally have a better outcome compared with hemodialysis (HD) starters, perhaps related to treatment characteristics or case mix. We previously showed that pre- and post-dialysis start clinical parameter trajectories are related to outcomes. The aim of this study was to investigate these trajectories in PD and HD starters. METHODS: This retrospective observational study analyzing data from the Fresenius Medical Care-chronic kidney disease (CKD) Registry from January 2009 to March 2018 examines trends in key clinical parameters through the transition period covering 12 months before to 12 months after dialysis start in 8,088 HD and 1,015 PD starters...
September 25, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Xiajing Che, Xiaoqian Yang, Jiayi Yan, Yanhong Yuan, Qing Ma, Liang Ying, Minfang Zhang, Qin Wang, Ming Zhang, Zhaohui Ni, Shan Mou
BACKGROUND: The effect of pretransplant peritoneal dialysis (PD) or hemodialysis (HD) modality on outcomes of kidney transplantation (KT) for end-stage renal disease (ESRD) is debatable. We evaluated the outcomes these modalities in KT from donor after cardiac death (DCD). METHODS: A cohort of 251 patients on HD, PD or pre-emptive who underwent first KT from DCD between January 2014 and December 2016 were prospectively analyzed to compare for outcomes on recovery of renal function, complications as well as patient and graft survival...
September 17, 2018: BMC Nephrology
P M Dogra, A K Hooda, G Shanmugraj, S K Pramanik
Continuous ambulatory peritoneal dialysis (CAPD) is a standard renal replacement therapy, but there is a lack of consensus for catheter insertion method and type of catheter used. We retrospectively analyzed 140 peritoneal dialysis catheters (PDC) inserted in 139 CAPD patients by two methods; percutaneous (Group "P," n = 47) and surgical mini laparotomy (Group "S," n = 93) technique over a 39-month period, with cumulative experience of 2415 catheter-months: 745 catheter-months for Group "P" and 1670 catheter-months for Group "S...
July 2018: Indian Journal of Nephrology
Abdou Niang, Arpana Iyengar, Valerie A Luyckx
PURPOSE OF REVIEW: To assess the use, access to and outcomes of hemodialysis and peritoneal dialysis in low-resource settings. RECENT FINDINGS: Hemodialysis tends to predominate because of costs and logistics, however services tend to be located in larger cities, often paid for out of pocket. Outcomes of dialysis-requiring acute kidney injury and end-stage kidney disease may be similar with hemodialysis and peritoneal dialysis, and therefore choice of therapy is dominated by availability, accessibility and patient or physician choice...
November 2018: Current Opinion in Nephrology and Hypertension
Sheru K Kansal, Jose A Morfin, Eric D Weinhandl
BACKGROUND: Peritoneal dialysis (PD) technique failure is often accompanied by complications that increase risks of hospitalization and death. Planned transition to hemodialysis may improve outcomes. Transitioning patients from PD to home hemodialysis (HHD) may improve continuity of lifestyle and facilitate delivery of more frequent treatment. METHODS: We analyzed United States Renal Data System (USRDS) data to compare the incidence of death and kidney transplant in patients who transferred from PD to HHD and matched patients who transferred from PD to in-center HD (IHD)...
July 31, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
William L Salzer
Peritoneal dialysis is an effective treatment modality for patients with end-stage renal disease. The relative use of peritoneal dialysis versus hemodialysis varies widely by country. Data from a 2004 survey reports the percentage of patients with end-stage renal disease treated with peritoneal dialysis to be 5%-10% in economically developed regions like the US and Western Europe to as much as 75% in Mexico. This disparity is probably related to the availability and access to hemodialysis, or in some cases patient preference for peritoneal over hemodialysis...
2018: International Journal of Nephrology and Renovascular Disease
Yun Sun, Gang Liu, Yali Jiang, Hui Wang, Hecun Xiao, Guangju Guan
BACKGROUND: Excessive eryptosis has been found in maintained hemodialysis or peritoneal dialysis patients. Signaling of triggering eryptosis includes oxidative stress, increased cytosolic Ca2+-activity, and ceramide. Erythropoietin (EPO) possesses the property of an antioxidant. The aim of this study was to investigate the ability of hydrogen peroxide (H2O2) on erythrocytes in vitro, and to assess the possible effects of recombinant human erythropoietin (rhEPO) on eryptosis. METHODS: One percent erythrocyte suspension was cultured in vitro in three kinds of media: Control group (Group C), H2O2 group (Group H), and EPO group (Group E)...
March 1, 2018: Clinical Laboratory
Clara Salame, Simon Eaton, George Grimble, Andrew Davenport
OBJECTIVE: Muscle wasting is associated with increased mortality and is commonly reported in dialysis patients. Hemodialysis (HD) and peritoneal dialysis (PD) treatments lead to protein losses in effluent dialysate. We wished to determine whether changes in current dialysis practice had increased therapy-associated nitrogen losses. DESIGN: Cross-sectional cohort study. METHODS: Measurement of total protein, urea and total nitrogen in effluent dialysate from 24-hour collections from PD patients, and during haemodiafiltration (HDF) and haemodialysis (HD) sessions...
September 2018: Journal of Renal Nutrition
Rajesh Jhorawat, Paras Shah, Pankaj Beniwal, Dhananjay Agarwal, Sandeep Nijhawan, Vinay Malhotra
We aimed to study the seroconversion rate in two arms of intradermal (ID) route: low dose with high-frequency and high dose with low-frequency hepatitis B (HB) vaccination in dialysis patients. A total of 56 patients, on either hemodialysis or peritoneal dialysis, were included. Patients were enrolled and randomized into two groups. The first group was immunized through the ID route and received weekly 10 μg of vaccine at 0, 1, 2, 3, 4, 5, 6, and 7 weeks (low-dose with high frequency). The second group was immunized through the ID route and received two doses of 40 μg at one-month interval (high dose with low frequency)...
March 2018: Saudi Journal of Kidney Diseases and Transplantation
S A K Sharifah Zamiah, Che Rosle Draman, Mohd Ramli Seman, A Fariz Safhan, R Rozalina, N I Nik Ruzni
Cardiovascular (CV) event is the most common cause of death in dialysis patients. Both traditional and nontraditional CV risk factors related to malnutrition, inflammation, and anemia are commonly found in this population. This study was conducted to evaluate the burden factors of CV risk factors and its management in our regularly dialyzed patients. It was a single-center, cross-sectional analysis of prevalent intermittent hemodialysis (IHD) and continuous ambulatory peritoneal dialysis (CAPD) patients followed up in our hospital...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
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