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Effects of the initial peritoneal dialysis (PD) prescription on clinical outcomes are unknown in Japan. We conducted a cohort study using data from Peritoneal Dialysis Outcomes and Practice Patterns Study. The patients were divided into two groups by the volume of the initial PD prescription (≤ 4 L/day or > 4 L/day).
View Article and Find Full Text PDFChronic kidney disease in older adults: challenges and opportunities for the primary care provider.
BMC Prim Care
November 2024
Department of Medicine, Division of Nephrology, Stanford University School of Medicine, Stanford, CA, USA.
Kidney disease and its comorbidities disproportionately affect older persons. Kidney disease modifying therapy is underutilized in older adults, as guidelines lack consensus on approaching diagnosis and treatment in older adults. This review aims to highlight the challenges presented by, and opportunities for, identifying and treating CKD in older adults.
View Article and Find Full Text PDFIncreasing Accessibility to Intradialytic Cycling in Rural and Remote Settings: Program Report.
Can J Kidney Health Dis
October 2024
University of Alberta, Edmonton, Canada.
Purpose Of Program: Access to exercise and rehabilitation is often lower in rural or remote areas and hemodialysis (HD) dependence imposes additional barriers. Intradialytic cycling (IDC) can improve HD-related symptoms, such as leg cramping, restless legs, and symptoms of depression, as well as physical function and fitness, but access to exercise professionals with this expertise is limited. To promote access to IDC in rural and remote HD units, we describe the implementation and initial evaluation of a novel IDC program using virtual assessment to safely prescribe and individualize IDC.
View Article and Find Full Text PDFAssociation of Dialysate Bicarbonate with Arrhythmia in the Monitoring in Dialysis Study.
Kidney360
October 2024
Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Article Synopsis
- Sudden death is a significant concern for hemodialysis patients, accounting for about 25% of their deaths, with more incidents occurring on the days they receive treatment.
- A study analyzed data from 66 patients using implantable loop recorders over 12 months to examine how higher levels of dialysate bicarbonate (DBIC) affected the occurrence of serious heart arrhythmias.
- The results showed that while fewer episodes of clinically significant arrhythmia were linked to DBIC levels over 35 mEq/L, this finding lost significance when factoring in potassium levels, highlighting the need for further research with larger sample sizes.
Implementing a multisite shared haemodialysis care programme.
BMJ Open Qual
October 2024
Churchill Hospital Oxford Kidney Unit, Oxford, UK
Adults receiving centre-based haemodialysis (HD) have low levels of patient activation which are associated with poorer outcomes. Shared haemodialysis care (SHC) describes an intervention whereby individuals are supported to undertake elements of their treatment to improve their activation levels and promote better self-care. This project aimed to increase the proportion of those performing SHC in seven HD centres within the Oxford Kidney Unit's catchment area.
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