Peritoneal Dialysis International最新文献

{"title":"Optimizing exit-site care for hospitalized peritoneal dialysis patients with weekly chlorhexidine-impregnated dressing.","authors":"Htay Htay, Wei Wang, Mathini Jayaballa, Su Fong Kok, Zheng Xi Kog, Khin Zar Li Lwin, Elizabeth Ley Oei, Chieh Suai Tan, Marjorie Wai Yin Foo","doi":"10.1177/08968608251344077","DOIUrl":"https://doi.org/10.1177/08968608251344077","url":null,"abstract":"<p><p>IntroductionPeritoneal dialysis (PD) catheter exit site care is crucial to prevent exit site or tunnel tract infection. Daily exit site care for hospitalized PD patients can be time-consuming for nurses. Therefore, an alternative approach with less frequent exit site care is needed.MethodsThe quality improvement (QI) initiative was conducted at a single center in Singapore from August 2021 to February 2022, during the COVID-19 pandemic. This initiative aimed to reduce nursing time spent on exit site care for hospitalized PD patients using weekly chlorhexidine-impregnated sponge dressings.ResultsA total of 211 PD patients received weekly chlorhexidine-impregnated dressings during their admission. The total length of stay was 3714 days, with a median stay of 6 (interquartile range: 3-13) days per patient. Most patients were Chinese (78%), and 59% were male. PD nurses spent a median of 104.9 min (Interquartile range [IQR]: 99.3-129.7) per patient per month on exit-site care with daily antibiotic dressing before this initiative. After the QI initiative, this was reduced to 31.3 min (IQR: 26.6-31.6), achieving a 70% reduction. A total of 696 chlorhexidine dressings were used, instead of an estimated 3714 conventional dressings. Nursing time for dressing changes was 116 h with chlorhexidine, versus an assumed 619 h with conventional daily dressing, resulting in a net saving of 503 h. The total cost for chlorhexidine dressings was Singapore Dollars (S$) 20,880, compared to estimated S$ 74,280 for conventional dressings, yielding a net savings of S$ 53,400. No patients developed exit-site infections, and no adverse events were observed with the chlorhexidine dressings.ConclusionsThe QI initiative showed that weekly chlorhexidine-impregnated dressing significantly reduced nursing time for exit-site care in hospitalized PD patients without short-term adverse events, potentially lowering healthcare costs.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608251344077"},"PeriodicalIF":2.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic challenges in peritoneal dialysis-associated peritonitis with atypical and rare pathogens: A new era of metagenomic next-generation sequencing precision diagnosis.","authors":"Xiao Dong, Chao Xie, Zhe Zhang, Hongjian Ye, Ruihua Liu, Wei Chen, Yao-Zhong Kong, Xiao Yang","doi":"10.1177/08968608251333879","DOIUrl":"https://doi.org/10.1177/08968608251333879","url":null,"abstract":"<p><p>Peritonitis caused by atypical and rare pathogens is challenging to diagnose. Although the International Society for Peritoneal Dialysis (ISPD) guidelines significantly improve the diagnostic rate by placing peritoneal dialysis fluid into blood culture bottles, peritonitis caused by atypical pathogens, such as tuberculosis and fungi, is difficult to diagnose due to challenges in culturing these organisms using traditional methods, leading to high mortality. Metagenomic next-generation sequencing (mNGS) technology has been widely used as an accurate diagnostic technique for infectious diseases. First used in identifying and quantifying environmental micro-organisms, mNGS technology can identify rare, novel, difficult-to-detect and mixed pathogens directly from clinical samples, and has potential in predicting antibiotic resistance. This paper summarizes the application of mNGS in atypical and rare pathogens peritonitis clinical cases in recent years, and provides reference for the diagnosis of peritonitis in combination with new ISPD guidelines and diagnostic techniques. The development and principles of mNGS technology, diagnostic efficiency in peritonitis, challenges in diagnosis of atypical and rare pathogen-associated peritonitis, and application of mNGS technology are discussed in detail. The development of mNGS technology provides clinicians with powerful tools to more accurately identify and treat peritonitis. Future research needs to focus on reducing costs, improving test accessibility, and developing new bioinformatics tools to better integrate mNGS results into clinical practice.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608251333879"},"PeriodicalIF":2.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incremental compared with full-dose peritoneal dialysis: A cost analysis from a third-party payer perspective in Australia.","authors":"Mary Ann Nicdao, Germaine Wong, Karine Manera, Kamal Sud, Surjit Tarafdar, Allison Jaure, Katrina Chau, Martin Howell","doi":"10.1177/08968608251326329","DOIUrl":"https://doi.org/10.1177/08968608251326329","url":null,"abstract":"<p><p>IntroductionIncremental peritoneal dialysis (PD) prescriptions, tailored to individual patient needs and residual kidney function, may offer patients greater dialysis-free time than full-dose PD and has the potential to yield substantial cost savings. We aimed to quantify the direct healthcare costs and resource utilization associated with incremental and full-dose PD from a third-party health service payer's perspective and estimate dialysis-free time and dialysis waste saved.MethodsWe recruited patients from a large dialysis service provider in Australia. We retrospectively analysed prospectively collected hospital data from 203 incident patients receiving PD over a 24-month period. Incremental PD was compared to full dose, considering costs related to consumables, multidisciplinary reviews, pathology, and in-patient costs.ResultsOf the 204 incident patients recruited in the study, 123 (60%) were prescribed incremental PD, with mean age of 62 years, and 66% being male. The total mean monthly outpatient cost ($AUD) for any dose of incremental PD was $339 (95% CI $152, -$526, p< .001) less than full dose, with PD consumables as the greatest contributor to the cost difference. At the end of the study, the mean dwell and exchange procedure times were 5065 h (4222-5908) and 455 h (403-507) lower in incremental PD than full dose, respectively, and incremental PD prescriptions saved >2 million litres of water, >9000 kg plastic and >8000 kg cardboard.ConclusionCompared to full dose, incremental PD minimizes dialysis time and is associated with lower costs and dialysis waste, driven largely by reduction in consumables use.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608251326329"},"PeriodicalIF":2.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obituary Prof. Dr Raymond (Ray) T. Krediet.","authors":"Dirk Gijsbert Struijk, Elisabeth Wilhelmina Boeschoten","doi":"10.1177/08968608251329191","DOIUrl":"https://doi.org/10.1177/08968608251329191","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":"45 3","pages":"133-134"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of intraperitoneal calcium for hungry bone syndrome following parathyroidectomy: A case report.","authors":"Taren Bettler, Mirna Vucak-Dzumhur, Gopala Rangan, Grahame Elder","doi":"10.1177/08968608241256846","DOIUrl":"10.1177/08968608241256846","url":null,"abstract":"<p><p>A man with hyperparathyroidism secondary to kidney failure on peritoneal dialysis underwent a parathyroidectomy with half-gland reimplantation complicated by severe hungry bone syndrome resulting in severe hypocalcaemia, hypotension and QT prolongation on ECG. He was initially managed with oral calcium and intravenous (IV) calcium chloride. Despite standard supportive treatment, attempts to wean IV therapy were unsuccessful. We report the novel use of intraperitoneal calcium to facilitate the weaning of IV calcium and discharge from hospital. A subsequent peritoneal membrane adequacy study did not demonstrate loss of peritoneal membrane adequacy.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"185-189"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141301316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing a peritoneal dialysis technique survival core outcome measure: A standardised outcomes in nephrology-peritoneal dialysis consensus workshop report.","authors":"Emma H Elphick, Karine E Manera, Andrea K Viecelli, Jonathan C Craig, Yeoungjee Cho, Angela Ju, Jenny I Shen, Martin Wilkie, Samaya Anumudu, Neil Boudville, Josephine Sf Chow, Simon J Davies, Patricia Gooden, Tess Harris, Arsh K Jain, Adrian Liew, Andrea Matus-Gonzalez, Noa Amir, Annie-Claire Nadeau-Fredette, Thu Nguyen, Angela Yee-Moon Wang, Daniela Ponce, Rob Quinn, Alison Jaure, David W Johnson, Mark Lambie","doi":"10.1177/08968608241287684","DOIUrl":"10.1177/08968608241287684","url":null,"abstract":"<p><p>BackgroundTechnique 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.MethodsWe conducted an online international consensus workshop to establish a core outcome measure of technique survival. Discussions were analysed thematically.ResultsFifty-five participants including 14 patients and caregivers from 13 countries took part in facilitated breakout discussions using video-conferencing. The following themes were identified: capturing important aspects of the outcome (requiring a core event to define the outcome, distinguishing temporary from permanent events, recognising heterogeneous experiences of transfers), adopting appropriate neutral nomenclature (conveying with clarity, avoiding negative connotations), and ensuring feasibility and applicability (capturing data relevant to clinical and research settings, ease of adoption). The suggested definitions for the core outcome measure were 'the event of a transfer to haemodialysis', or 'discontinuation of peritoneal dialysis'. Applying the principles described within the workshop, defining the outcome measure as a 'transfer to haemodialysis' was preferable.ConclusionsIt is proposed that the core outcome of technique survival is redefined as 'transfer to haemodialysis' and that its components are standardised using simple, neutral terminology Components considered important by stakeholders included recording the reasons for transfer from peritoneal dialysis, and focussing on permanent events whilst ensuring the outcome remains easy to implement.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"153-161"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations in provider practices in remote patient monitoring on peritoneal dialysis in the USA and Canada.","authors":"O El Shamy, R Fadel, E D Weinhandl, G Abra, M Salani, J I Shen, J Perl, T S Malavade, D Chatoth, M V Naljayan, K B Meyer, S Q Lew, M J Oliver, T A Golper, J Uribarri, R R Quinn","doi":"10.1177/08968608241270294","DOIUrl":"10.1177/08968608241270294","url":null,"abstract":"<p><p>Automation has allowed clinicians to program PD treatment parameters, all while obtaining extensive individual treatment data. This data populates in a centralized online platform shortly after PD treatment completion. Individual treatment data available to providers includes patients' vital signs, alarms, bypasses, prescribed PD treatment, actual treatment length, individual cycle fill volumes, ultrafiltration volumes, as well as fill, dwell, and drain times. However, there is no guidance about how often or if this data should be assessed by the clinical team members. We set out to determine current practice patterns by surveying members of the home dialysis team managing PD patients across the United States and Canada. A total of 127 providers completed the survey. While 91% of respondents reported having access to a remote monitoring platform, only 31% reported having a standardized protocol for data monitoring. Rating their perceived importance of having a standard protocol for remote data monitoring, on a scale of 0 (not important at all) to 10 (extremely important), the average response was 8 (physicians 7; nurses 9). Most nurses reported reviewing the data multiple times per week, whereas most physicians reported viewing the data only during regular/monthly visits. Although most of the providers who responded have access to remote monitoring data and feel that regular review is important, the degree of its utilization is variable, and the way in which the information is used is not commonly protocolized. Working to standardize data interpretation, testing algorithms, and educating providers to help process and present the data are important next steps.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"190-194"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peritoneal dialysis and kidney transplantation: Your questions answered.","authors":"Joshua Shapiro, Jeffrey Schiff, Jeffrey Perl","doi":"10.1177/08968608251313679","DOIUrl":"10.1177/08968608251313679","url":null,"abstract":"<p><p>Peritoneal dialysis (PD) and kidney transplantation are important therapeutic options in patients with advanced kidney disease. This article delineates the relationship between PD and kidney transplantation in several key domains, including: (1) Comparative merits and limitations of PD versus center-based hemodialysis prior to kidney transplantation, (2) Patient outcomes after kidney transplantation in individuals receiving PD prior to kidney transplantation, (3) Perioperative management strategies of patients receiving PD at the time of kidney transplantation, and (4) The relative advantages and clinical outcomes of PD use following kidney allograft failure compared to other modalities. This article aims to provide comprehensive guidance for optimizing care across the PD-kidney transplant transitions continuum.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"142-152"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing health-related quality of life and utility scores of patients undergoing hemodialysis and continuous ambulatory peritoneal dialysis in Indonesia.","authors":"M Rifqi Rokhman, Yulia Wardhani, Dwi Lestari Partiningrum, Barkah Djaka Purwanto, Ika Ratna Hidayati, Arofa Idha, Jarir At Thobari, Maarten J Postma, Cornelis Boersma, Jurjen van der Schans","doi":"10.1177/08968608241285969","DOIUrl":"10.1177/08968608241285969","url":null,"abstract":"<p><p>BackgroundAlthough both hemodialysis and continuous ambulatory peritoneal dialysis (CAPD) are covered by national healthcare insurance, 98% of kidney failure disease patients are treated with hemodialysis. This study compared the health-related quality of life (HRQoL) and utility scores of patients receiving hemodialysis and CAPD in Indonesia and determined factors associated with HRQoL and utility scores.MethodsA cross-sectional study was performed using the Kidney Disease Quality of Life-36 and EQ-5D-5L instruments at six hospitals. Utility scores were presented as SF-6D and EQ-5D scores. Factors associated with the EQ-5D were evaluated using Tobit regressions due to ceiling effects, while the SF-6D and HRQoL were assessed using generalized linear models since the data were not normally distributed.ResultsAmong the 613 patients, 76% were treated with hemodialysis. After adjusting for sociodemographic characteristics and clinical parameters, CAPD patients reported better HRQoL compared to hemodialysis patients in terms of the SF-6D (<i>p</i> = .038), mental component summary (<i>p</i> = .020), symptoms (<i>p</i> = .005), and effects of kidney disease (<i>p</i><.001), but no significant differences were reported in EQ-5D (<i>p</i> = .083), physical component summary (<i>p</i> = .323), burden of kidney disease (<i>p</i> = .111), and kidney summary scores (<i>p</i> = .068). Poorer HRQoL and utility scores were likely experienced by older patients who were male, married, with diabetes, treated in Class A hospitals, and with lower education, hemoglobin, and albumin levels.ConclusionIn Indonesia, patients treated with CAPD had better HRQoL and utility scores compared to patients undergoing hemodialysis. Therefore, CAPD should be promoted by healthcare professionals as the first treatment option for patients who are eligible for both hemodialysis and CAPD.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"162-173"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing a peritoneal dialysis technique survival core outcome measure: We look forward to the next possession.","authors":"Chang Huei Chen, Isaac Teitelbaum","doi":"10.1177/08968608241303201","DOIUrl":"10.1177/08968608241303201","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"140-141"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}