Publications by authors named "M Lambie"

Objective: The proportion of people having home dialysis for kidney disease varies considerably by treating centre, socioeconomic deprivation levels in the area and to some extent ethnicity. This study aimed to gain in-depth insights into cultural and organisational factors contributing to this variation in uptake.

Design: This is the first ethnographic study of kidney centre culture to focus on home dialysis uptake.

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Key Points: CKD-associated pruritus is highly prevalent among peritoneal dialysis patients. Pruritus is associated with reduced health-related quality of life, and the composite of mortality and transfer to hemodialysis for peritoneal dialysis patients. Efforts to better identify and manage pruritus in this population are needed.

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Background: Technique survival, also reported with negative connotations as technique failure or transfer from peritoneal dialysis to haemodialysis, has been identified by patients, caregivers and health professionals as a critically important outcome to be reported in all trials. However, there is wide variation in how peritoneal dialysis technique survival is defined, measured and reported, leading to difficulty in comparing or consolidating results.

Methods: We conducted an online international consensus workshop to establish a core outcome measure of technique survival.

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Article Synopsis
  • - Pruritus, or itchiness, is a common issue affecting 43% of peritoneal dialysis patients, with prevalence varying by country, being notably higher in Thailand (50%) and lower in the U.S. (33%).
  • - Factors like diabetes, low protein levels, and high phosphorus levels are linked to moderate to severe pruritus, while increased urine output appears to reduce itchiness.
  • - Patients suffering from severe pruritus report poorer mental and physical health, and they also have a higher risk of death or needing to switch to hemodialysis (HD), with a 12% increased risk associated with moderate to extreme itching.
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Peritoneal dialysis adoption and technique survival is affected by limitations related to peritoneal membrane longevity and metabolic alterations. Indeed, almost all peritoneal dialysis fluids exploit glucose as an osmotic agent that rapidly diffuses across the peritoneal membrane, potentially resulting in metabolic abnormalities such as hyperglycemia, hyperinsulinemia, obesity, and hyperlipidemia. Moreover, glucose-degradation products generated during heat sterilization, other than glucose itself, induce significant morphological and functional changes in the peritoneum leading to ultrafiltration failure.

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