Kidney Week 2025 Annual Meeting-What's New at Home (Dialysis)?

Video Transcription

Video Summary

The session opened the ASN “What’s New at Home” oral abstracts on home dialysis, featuring research from multiple countries and sectors.<br /><br />A Thai multicenter randomized trial in volume-overloaded CAPD patients compared three peritoneal dialysis strategies: conventional CAPD, nocturnal intermittent PD (NIPD), and CAPD substituting one dwell with icodextrin. Icodextrin was associated with improved patient and infection-related survival and fewer hospitalizations, plus lower glucose absorption and triglycerides; benefits were not seen in high solute transporters. NIPD showed lower creatinine clearance and higher phosphate, suggesting reduced phosphate removal.<br /><br />A second Thai multicenter open-label RCT tested one month of whey protein supplementation (30 g/day) plus dietary counseling in hypoalbuminemic PD patients with peritonitis. Supplementation significantly improved serum albumin over 120 days and reduced a composite adverse outcome including refractory peritonitis (HR ~0.71), with more gastrointestinal symptoms.<br /><br />A US National Inpatient Sample analysis (2003–2018) evaluated racial/ethnic disparities among hospitalized PD patients. Black, Hispanic, and Asian/Pacific Islander patients had higher PD-related complications; Black patients had lower mortality and costs, Hispanics had higher costs, and Asians had higher sepsis and procedure burdens. Limitations included administrative coding and lack of socioeconomic variables.<br /><br />A VA qualitative study described how outsourcing home dialysis to community providers increases complexity, fragmentation, and administrative burden, suggesting staffing and infrastructure improvements could raise PD access for veterans.<br /><br />USRDS/SNF analyses showed increasing conversion of PD patients to hemodialysis during skilled nursing facility stays (approaching 50% by 2022), with <20% returning to PD after discharge.<br /><br />Registry data on pleuroperitoneal leaks (~2% incidence) found most patients switched to HD; pleurodesis, though infrequently used, had high PD resumption success in those reattempting.<br /><br />Industry modeling suggested point-of-care PD fluid generation could reduce shipping, packaging, and emissions substantially.<br /><br />USRDS data in ADPKD showed rising PD uptake over time, with PD associated with lower mortality and higher transplant rates versus HD.<br /><br />Finally, a large provider study of “bridge” oral antibiotics for suspected peritonitis found no increase in culture-negative episodes and no overall hospitalization reduction, though benefit appeared in gram-positive peritonitis.

Asset Subtitle

Moderator(s): Caroline Hsu, Ankur Shah

Presentation(s):

Effects of Peritoneal Dialysis Modalities on Hypervolemic Patients: A Randomized Controlled Trial - Suchai Sritippayawan
Improving Nutritional and Clinical Outcomes in Peritoneal Dialysis (PD) Peritonitis: A Randomized Trial of Whey Protein Supplementation - Talerngsak Kanjanabuch
Racial Disparities in In-Hospital Outcomes and Health Care Costs Among Patients with ESKD on Peritoneal Dialysis: A 15-Year National Analysis - Jose Arriola Montenegro
Through the Looking Glass: Characterizing the Complexity of Outsourcing Veterans Affairs Home Dialysis - Yuvaram Reddy
Conversions to Hemodialysis for Patients on Peritoneal Dialysis Admitted to Skilled Nursing Facilities in the United States, 2012-2022 - Christopher Knapp
Pleuroperitoneal Leaks: Diagnosis, Management, and Outcomes in the North American Peritoneal Dialysis Catheter Registry - Vincent Li
Advancing Green Dialysis: Environmental Benefits of Point-of-Care Peritoneal Dialysis Dialysate Generation - Mandar Gori
Peritoneal Dialysis in ADPKD - Samantha Gunning
Oral Antibiotic Therapy and Hospitalization in Peritoneal Dialysis-Associated Peritonitis - Rachael Lazar

Note: Continuing education credits are not being offered for this session.

Meta Tag

Date 11/7/2025

Pathway 1 Dialysis

Session ID 519843

Keywords

home dialysis

peritoneal dialysis

CAPD

icodextrin

nocturnal intermittent peritoneal dialysis (NIPD)

peritonitis

whey protein supplementation

racial and ethnic disparities

Veterans Affairs (VA) care coordination

skilled nursing facility (SNF) conversion to hemodialysis

pleuroperitoneal leak

autosomal dominant polycystic kidney disease (ADPKD)