Abstract
This issue of Peritoneal Dialysis International (PDI) covers a broad canvas, including novel research concepts and patient experience. Peritoneal dialysis is delivered by replacing dialysate once the osmotic agent concentration (predominantly glucose) has dissipated with time. Are there advantages to establishing a mechanism where the dialysate glucose is continually replenished in order to maintain a constant concentration? This question is explored through a commentary from Magnus Braide in which he describes mathematical models that are based on this concept, examining intraperitoneal glucose concentrations, glucose absorption, ultrafiltration volumes, and sodium removal (1). The dynamic interaction of these components is complex—but, through better understanding of their interrelations, may offer opportunities to individualize therapy to enhance volume and sodium removal.
A phone survey about swimming conducted with nurses from Australian PD units provides practical information for patients and teams (2). The majority of units recommend swimming for people on PD as long as the PD catheter and exit site are covered with a waterproof-type dressing. Considerable variation exists in the specific advice between units, and there is work to be done to standardize guidance.
The Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) continues to provide enlightening insights into international differences in practice patterns, and a paper in this issue examines anemia and its treatment across contributing centers (3). Figure 4 from that paper, displayed on the front cover of this issue, demonstrates wide differences in the prescription of intravenous (IV) iron in patients on PD between contributing countries. The relevance of this question has increased in light of the hemodialysis PIVOTAL study, in which high-dose IV iron resulted in lower epoeitin usage as well as a reduction in the composite outcome of myocardial infarction, stroke, or hospitalization for heart failure (4).
Finally, this is the last issue of PDI with our current publisher, Multimed. Multimed and founder Lorne Cooper worked with Dimitri Oreopoulos to establish what was originally the Peritoneal Dialysis Bulletin, subsequently becoming PDI. It is thanks to their vision that this journal is center stage in the advancement of high-quality care for people who require PD. We remain indebted to them as the work is continued through the International Society for Peritoneal Dialysis (ISPD) to the benefit of patients worldwide. As Editor-in-Chief, I have found in Multimed an excellent partner in the preparation and publication of this journal, and for that I thank them.
Footnotes
M Wilkie has advised Triomed AB.