2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T76a,ABSTRACT Residual kidney function (RKF) is a key determinant of outcomes in patients undergoing peritoneal dialysis (PD), contributing to solute clearance, volume regulation, reduced inflammation, and improved survival. Nevertheless, RKF commonly declines after PD initiation, often due to potentially modifiable clinical and treatment-related factors. This narrative review summarizes current evidence on the mechanisms underlying RKF loss in PD and evaluates established and emerging strategies to preserve RKF in contemporary practice. Major contributors to RKF decline include hemodynamic instability, cumulative glucose exposure, inflammation and peritonitis, nephrotoxic medications, dialysis-related volume shifts, and kidney disease-specific conditions. Conventional strategies such as incremental and individualized PD prescriptions, use of biocompatible and glucose-sparing solutions, careful volume and blood pressure management, renin–angiotensin–aldosterone system blockade, infection prevention, and tailored management after kidney allograft failure are reviewed. Importantly, current guideline-based strategies largely address these factors in isolation. We propose that RKF preservation should be approached through an integrated, mechanism-based framework, in which cumulative glucose exposure represents a central modifiable mediator linking multiple pathways of kidney injury. In this context, remote monitoring and artificial intelligence-based tools may serve as enabling platforms that integrate longitudinal clinical and treatment data, supporting individualized and proactive care. Preserving RKF should remain a central therapeutic goal in PD, and combining established physiological principles with modern digital technologies may provide a more effective framework for improving long-term patient outcomes.31:T750,Recent technologic advances in neonatal dialysis have changed current dialysis practices. The goal of this study was to define demographics, diagnoses, initial dialysis modality, modality changes, and outcomes of neonates receiving dialysis. Retrospective, multicenter cohort of neonates (≤ 30 days of age) from 26 U.S. centers, who received dialysis between 6/2017 and 5/2022. Measures of central tendency were calculated to describe the cohort stratified by the primary dialysis-related diagnosis including acute kidney injury requiring dialysis (AKI-D), stage 5 chronic kidney disease (CKD 5), hyperammonemia, and other causes. The primary outcome was death during the initial hospitalization. For the 405 neonates in this cohort, AKI-D (57%) was the most common dialysis-related diagnosis, followed by CKD 5 (29%) and hyperammonemia (11%). Most neonates (58%) had a birth weight between 2500 and 3500 g. The most common initial neonatal dialysis modality was continuous kidney replacement therapy (CKRT) with (35%) or without extracorporeal membrane oxygenation (ECMO) (36%). Only 26% of neonates received peritoneal dialysis (PD) as their initial dialysis modality. Thirty percent of neonates received more than one dialysis modality. The overall mortality was 50% (59% in AKI-D and 41% in CKD 5). Withdrawal of care was reported as the most common reason for death. The odds of death were lower for neonates with AKI-D receiving PD as the initial modality when compared to CKRT (aOR 0.28, 95% CI 0.09-0.84) or CKRT with ECMO (aOR 0.24, 95% CI 0.10-0.58), but this association was not seen in neonates with CKD 5. This multicenter, contemporary neonatal dialysis cohort shows increased use of CKRT as the initial dialysis modality but also shows that the mortality of neonates on dialysis remains high. Additional studies on modern neonatal dialysis are needed.32:Ta4c,Abstract Background Recent technologic advances in neonatal dialysis have changed current dialysis practices. The goal of this study was to define demographics, diagnoses, initial dialysis modality, modality changes, and outcomes of neonates receiving dialysis. Methods Retrospective, multicenter cohort of neonates (≤ 30 days of age) from 26 U.S. centers, who received dialysis between 6/2017 and 5/2022. Measures of central tendency were calculated to describe the cohort stratified by the primary dialysis-related diagnosis including acute kidney injury requiring dialysis (AKI-D), stage 5 chronic kidney disease (CKD 5), hyperammonemia, and other causes. The primary outcome was death during the initial hospitalization. Results For the 405 neonates in this cohort, AKI-D (57%) was the most common dialysis-related diagnosis, followed by CKD 5 (29%) and hyperammonemia (11%). Most neonates (58%) had a birth weight between 2500 and 3500 g. The most common initial neonatal dialysis modality was continuous kidney replacement therapy (CKRT) with (35%) or without extracorporeal membrane oxygenation (ECMO) (36%). Only 26% of neonates received peritoneal dialysis (PD) as their initial dialysis modality. Thirty percent of neonates received more than one dialysis modality. The overall mortality was 50% (59% in AKI-D and 41% in CKD 5). Withdrawal of care was reported as the most common reason for death. The odds of death were lower for neonates with AKI-D receiving PD as the initial modality when compared to CKRT (aOR 0.28, 95% CI 0.09–0.84) or CKRT with ECMO (aOR 0.24, 95% CI 0.10–0.58), but this association was not seen in neonates with CKD 5. Conclusions This multicenter, contemporary neonatal dialysis cohort shows increased use of CKRT as the initial dialysis modality but also shows that the mortality of neonates on dialysis remains high. Additional studies on modern neonatal dialysis are needed. Graphical abstract 33:T585,In patients with incident end-stage kidney disease (ESKD), hyperkalemia (HyperK) is a common indication for initiating kidney replacement therapy (KRT). Hemodialysis (HD) and peritoneal dialysis (PD) both effectively reduce serum potassium, but HD is often considered superior due to its perceived faster efficiency. However, evidence supporting this perception remains limited. We hypothesized that HD and PD would be equally effective for the management of severe HyperK during hospitalization. We conducted a prospective cohort study at the Nephrology Department of Hospital Civil de Guadalajara. Consecutive, dialysis-naïve patients hospitalized with ESKD and severe HyperK (serum potassium >6.5 mEq/L at admission) between 2022 and 2024 were included. The modality of KRT (HD vs PD) was determined by the treating nephrology team. The primary outcome was the trajectory of serum potassium reduction between groups. Secondary outcomes included daily potassium trajectory, catheter dysfunction, length of stay and mortality. Eighty-two patients were included: 34 initiated PD, 37 HD and 11 received conservative management. Baseline demographic and clinical characteristics were similar across groups ( In this prospective cohort of ESKD patients with severe HyperK, both PD and HD achieved comparable potassium reduction and clinical outcomes, supporting PD as an effective alternative for urgent-start KRT.34:Tb3b,ABSTRACT Introduction In patients with incident end-stage kidney disease (ESKD), hyperkalemia (HyperK) is a common indication for initiating kidney replacement therapy (KRT). Hemodialysis (HD) and peritoneal dialysis (PD) both effectively reduce serum potassium, but HD is often considered superior due to its perceived faster efficiency. However, evidence supporting this perception remains limited. We hypothesized that HD and PD would be equally effective for the management of severe HyperK during hospitalization. Methods We conducted a prospective cohort study at the Nephrology Department of Hospital Civil de Guadalajara. Consecutive, dialysis-naïve patients hospitalized with ESKD and severe HyperK (serum potassium >6.5 mEq/L at admission) between 2022 and 2024 were included. The modality of KRT (HD vs PD) was determined by the treating nephrology team. The primary outcome was the trajectory of serum potassium reduction between groups. Secondary outcomes included daily potassium trajectory, catheter dysfunction, length of stay and mortality. Results Eighty-two patients were included: 34 initiated PD, 37 HD and 11 received conservative management. Baseline demographic and clinical characteristics were similar across groups (P > .05). Median age was 65 years [interquartile range (IQR) 53–74], with diabetes in 33% and hypertension in 53%. Median admission potassium was 6.99 mEq/L (6.7–7.6), serum creatinine 15.9 mg/dL (11.5–23.1) and estimated glomerular filtration rate 2.91 mL/min/1.73 m² (1.80–4.09). The PD group underwent a mean of 45 (±15) exchanges during hospitalization, and the HD group received 4.6 (±1) sessions. Serum potassium decreased similarly in both groups (P > .05), with substantial reductions on Day 1 (PD 6.03 mEq/L; HD 5.90 mEq/L) and stabilization by Day 5 through Day 15. Catheter dysfunction occurred in 11% of patients, with similar rates between groups, hospitalization median was 5 days (IQR 3–8) and 12-month mortality was 26.8%, without differences between modalities. Conclusions In this prospective cohort of ESKD patients with severe HyperK, both PD and HD achieved comparable potassium reduction and clinical outcomes, supporting PD as an effective alternative for urgent-start KRT. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Peritoneal Dialysis: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Peritoneal Dialysis (modality). Clinician-written summaries and actionable practice insights. 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Key mechanisms of dialytrauma — hemodynamic instability, blood–membrane inflammatory activation, metabolic/osmotic perturbations, and access-related complications — vary by modality and can impair tubular repair and promote progression to CKD.","limitations":"As a narrative review, it does not pool quantitative data or perform systematic analysis. No head-to-head RCT data are synthesized to definitively rank modalities. Recommendations are largely expert-based and may not account for resource variability across clinical settings.","practice_takeaway":"Minimize unnecessary RRT exposure, excessive intensity, and hemodynamic instability regardless of modality to support renal recovery in AKI. Tailor RRT choice to individual patient hemodynamics and risk factors for dialytrauma rather than applying a one-size-fits-all approach."}},{"doi":"10.2215/cjn.0000001174","pmid":"42384446","title":"Preserving Peritoneal Membrane Performance","journal_title":"Clinical Journal of the American Society of Nephrology","journal_issn":"1555-9041","published_at":"2026-07-01T00:00:00.000Z","url":"https://doi.org/10.2215/cjn.0000001174","source_score":11,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-06T13:36:21.219Z","updated_at":"2026-07-06T13:36:21.219Z","tags":[{"paper_doi":"10.2215/cjn.0000001174","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.2215/cjn.0000001174","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.2215/cjn.0000001174","tag_type":"condition","value":"End-Stage Kidney Disease","value_numeric":null},{"paper_doi":"10.2215/cjn.0000001174","tag_type":"condition","value":"Peritoneal Dialysis Membrane Dysfunction","value_numeric":null},{"paper_doi":"10.2215/cjn.0000001174","tag_type":"condition","value":"Ultrafiltration Failure","value_numeric":null},{"paper_doi":"10.2215/cjn.0000001174","tag_type":"generic","value":"alanyl-glutamine","value_numeric":null},{"paper_doi":"10.2215/cjn.0000001174","tag_type":"generic","value":"carnitine","value_numeric":null},{"paper_doi":"10.2215/cjn.0000001174","tag_type":"generic","value":"icodextrin","value_numeric":null},{"paper_doi":"10.2215/cjn.0000001174","tag_type":"generic","value":"xylitol","value_numeric":null},{"paper_doi":"10.2215/cjn.0000001174","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.2215/cjn.0000001174","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.2215/cjn.0000001174","tag_type":"modality","value":"Peritoneal Dialysis","value_numeric":null},{"paper_doi":"10.2215/cjn.0000001174","tag_type":"modality","value":"RAAS Inhibitor","value_numeric":null},{"paper_doi":"10.2215/cjn.0000001174","tag_type":"modality","value":"SGLT2 Inhibitor","value_numeric":null},{"paper_doi":"10.2215/cjn.0000001174","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.2215/cjn.0000001174","tag_type":"warning","value":"No sample size is applicable as this is a review article with no primary patient cohort.","value_numeric":null},{"paper_doi":"10.2215/cjn.0000001174","tag_type":"warning","value":"The age group is assumed to be adult, as PD membrane preservation strategies are predominantly studied in adult populations; pediatric applicability is not discussed in the abstract.","value_numeric":null},{"paper_doi":"10.2215/cjn.0000001174","tag_type":"warning","value":"This is a narrative review; conclusions reflect the author's synthesis rather than a systematic or meta-analytic methodology.","value_numeric":null}],"summaries":{"what_studied":"This review examines strategies to preserve peritoneal membrane function in peritoneal dialysis (PD) patients, covering physiology, pathophysiology, and both proven and investigational interventions to prevent ultrafiltration (UF) failure and solute clearance loss.","key_result":"RAAS inhibition is the only proven strategy to prospectively preserve peritoneal membrane function. Evidence for neutral pH/low glucose degradation product (GDP) fluids is equivocal. Membrane rest after UF failure appears beneficial. Alanyl-glutamine additives, SGLT2 inhibitors, and xylitol/carnitine-based fluids are promising but unproven.","limitations":"This is a narrative review without systematic search methodology or meta-analytic pooling. Most emerging strategies (alanyl-glutamine, SGLT2 inhibitors, xylitol/carnitine) lack large randomized trial evidence. Benefits of icodextrin, steady-state glucose concentration, and incremental PD remain unknown.","practice_takeaway":"Consider RAAS inhibition in all eligible PD patients as the only evidence-based strategy to protect the peritoneal membrane. Clinicians should be cautious about assuming benefit from low-GDP/neutral pH fluids until stronger evidence emerges."}},{"doi":"10.1007/s00467-026-07410-7","pmid":"42347844","title":"Experiences of adults who underwent peritoneal dialysis in childhood: retrospective and qualitative study","journal_title":"Pediatric Nephrology","journal_issn":"0931-041X","published_at":"2026-06-25T00:00:00.000Z","url":"https://doi.org/10.1007/s00467-026-07410-7","source_score":5,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-04T13:26:21.768Z","updated_at":"2026-07-04T13:26:21.768Z","tags":[{"paper_doi":"10.1007/s00467-026-07410-7","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07410-7","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07410-7","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07410-7","tag_type":"condition","value":"Chronic Kidney Disease","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07410-7","tag_type":"condition","value":"End-Stage Kidney Disease","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07410-7","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07410-7","tag_type":"level_of_evidence","value":"6","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07410-7","tag_type":"modality","value":"Peritoneal Dialysis","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07410-7","tag_type":"sample_size","value":"n=18","value_numeric":18},{"paper_doi":"10.1007/s00467-026-07410-7","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07410-7","tag_type":"study_design","value":"Qualitative Study","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07410-7","tag_type":"warning","value":"No numerical outcome data (e.g., frequencies of specific themes) were reported in the abstract; all findings are descriptive themes only.","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07410-7","tag_type":"warning","value":"The full text extracted appears to belong primarily to a large Turkish nephrology registry report (2024 annual data), not the qualitative PD study described in the abstract. The summary is based on the abstract and results sections only, as the qualitative study content was not present in the extracted pages.","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07410-7","tag_type":"warning","value":"The paper metadata indicates the PDF language is Turkish and was created in October 2025, though the DOI publication date is listed as June 2026 — there may be a pre-publication discrepancy.","value_numeric":null}],"summaries":{"what_studied":"This retrospective qualitative study interviewed 18 adults in Izmir, Turkey who had received at least 6 months of peritoneal dialysis (PD) during childhood, exploring how PD treatment affected their lives across psychological, daily living, social, and academic domains.","key_result":"Four major theme areas emerged: (1) **Psychological effects** — fear, shock, sadness, hopelessness, and shame; (2) **Daily life effects** — dietary changes, altered body image, medication burden, repeated hospitalizations, and adaptation challenges; (3) **Social effects** — isolation, need for a dedicated PD room, reliance on social support, and disrupted personal relationships; (4) **Academic effects** — absenteeism, educational interruptions, academic failure, and forced career changes.","limitations":"- Small sample (n=18) from a single city limits generalizability.\n- Retrospective design relies on long-term recall, introducing memory bias.\n- Snowball sampling may introduce selection bias toward participants with stronger adverse experiences.","practice_takeaway":"Children on PD face wide-ranging psychological, social, and academic burdens that persist into adulthood — clinicians should proactively link pediatric PD patients with psychological support, school liaison services, and peer networks. Routine assessment of body image, social isolation, and academic functioning should be part of PD follow-up care."}},{"doi":"10.1681/asn.0000001152","pmid":"42240452","title":"Ultrafiltration and Sodium Removal in Steady Concentration Peritoneal Dialysis","journal_title":"Journal of the American Society of Nephrology","journal_issn":"1046-6673","published_at":"2026-06-04T00:00:00.000Z","url":"https://doi.org/10.1681/asn.0000001152","source_score":33,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-10T14:24:39.612Z","updated_at":"2026-06-10T14:24:39.612Z","tags":[{"paper_doi":"10.1681/asn.0000001152","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1681/asn.0000001152","tag_type":"brand","value":"Carry Life UF","value_numeric":null},{"paper_doi":"10.1681/asn.0000001152","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1681/asn.0000001152","tag_type":"condition","value":"End-Stage Kidney Disease","value_numeric":null},{"paper_doi":"10.1681/asn.0000001152","tag_type":"condition","value":"Peritoneal Dialysis-Associated Fluid Overload","value_numeric":null},{"paper_doi":"10.1681/asn.0000001152","tag_type":"generic","value":"dextrose peritoneal dialysis solution","value_numeric":null},{"paper_doi":"10.1681/asn.0000001152","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1681/asn.0000001152","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1681/asn.0000001152","tag_type":"modality","value":"Peritoneal Dialysis","value_numeric":null},{"paper_doi":"10.1681/asn.0000001152","tag_type":"sample_size","value":"n=19","value_numeric":19},{"paper_doi":"10.1681/asn.0000001152","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1681/asn.0000001152","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1681/asn.0000001152","tag_type":"warning","value":"Sample size is very small (n=19); the crossover design and short duration limit confidence in safety conclusions.","value_numeric":null},{"paper_doi":"10.1681/asn.0000001152","tag_type":"warning","value":"The Carry Life UF system is a novel device; brand classification is based on the name as cited in the abstract.","value_numeric":null},{"paper_doi":"10.1681/asn.0000001152","tag_type":"warning","value":"The full text pages retrieved appear to be a 2026 ASN Media Kit (advertising rate card), not the article body — clinical data are drawn exclusively from the abstract and results section provided. Some study details (e.g., full adverse event list, washout period, randomization method) could not be verified from the available text.","value_numeric":null}],"summaries":{"what_studied":"This prospective, multicenter, randomized crossover trial compared steady concentration peritoneal dialysis using the Carry Life UF system versus standard 2.5% dextrose CAPD exchanges in 19 adults over 4 weeks per arm, focusing on ultrafiltration (UF) volume, sodium removal, and glucose UF efficiency.","key_result":"Carry Life UF exceeded the prespecified 250 ml superiority margin: mean UF volume was 513 ml vs. 132 ml for control (mean increase 381 ml, 95% CI 285–477 ml). Peritoneal sodium removal increased by 43 mmol/exchange (95% CI 32–54), and glucose UF efficiency improved by 6.4 ml/g (95% CI 3.7–9.1). Two peritonitis episodes occurred, one in each arm.","limitations":"- Very small sample (n=19), limiting generalizability.\n- Short 4-week home phase per arm may not reflect long-term safety or efficacy.\n- Crossover design with mostly average peritoneal transporters (12/19); results may differ in other transport categories.","practice_takeaway":"For CAPD patients needing better fluid and sodium management, replacing one daily 2.5% dextrose exchange with Carry Life UF 3 days/week substantially increased UF volume and sodium removal with a comparable safety profile. Clinicians should note the small trial size and short duration before broad adoption."}},{"doi":"10.1093/ckj/sfag131","pmid":null,"title":"Preserving residual kidney function in peritoneal dialysis: from conventional approaches to contemporary practice","journal_title":"Clinical Kidney Journal","journal_issn":"2048-8505","published_at":"2026-04-25T00:00:00.000Z","url":"https://doi.org/10.1093/ckj/sfag131","source_score":21,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-04-30","doi":"10.1093/ckj/sfag131","days":"14","issn":"2048-8505","rank":"10","field":"Clinical Medicine","score":"21","category":"Urology & Nephrology","categories":["Urology & Nephrology"],"_categories":["Urology & Nephrology"]},"pubmed":null,"crossref":{"DOI":"10.1093/ckj/sfag131","URL":"https://doi.org/10.1093/ckj/sfag131","ISSN":["2048-8505","2048-8513"],"link":[{"URL":"https://academic.oup.com/ckj/advance-article-pdf/doi/10.1093/ckj/sfag131/68159306/sfag131.pdf","content-type":"application/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https://academic.oup.com/ckj/article-pdf/19/5/sfag131/68159306/sfag131.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https://academic.oup.com/ckj/article-pdf/19/5/sfag131/68159306/sfag131.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":"5","score":1,"title":["Preserving residual kidney function in peritoneal dialysis: from conventional approaches to contemporary practice"],"author":[{"given":"Haci Hasan","family":"Yeter","sequence":"first","affiliation":[{"name":"Hacettepe 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Level of evidence set to 5 accordingly.","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag131","tag_type":"warning","value":"The proposed integrated framework and AI-based monitoring approach are conceptual; no clinical trial data are presented to validate this model.","value_numeric":null}],"summaries":{"what_studied":"This narrative review evaluates mechanisms of residual kidney function (RKF) decline in peritoneal dialysis (PD) patients and assesses established and emerging strategies to preserve RKF, including incremental PD, biocompatible solutions, RAAS blockade, volume management, and AI/remote monitoring tools.","key_result":"Multiple modifiable contributors to RKF loss are identified — including hemodynamic instability, cumulative glucose exposure, peritonitis, nephrotoxins, and volume shifts — and the authors propose cumulative glucose exposure as a central mediator linking these pathways, supporting an integrated, mechanism-based preservation framework.","limitations":"As a narrative review, it does not include systematic search methods or meta-analytic pooling, limiting the strength of evidence synthesis. Current guideline strategies are noted to address RKF risk factors in isolation rather than as an integrated framework, and the proposed AI/remote monitoring approach remains theoretical without clinical trial validation.","practice_takeaway":"Clinicians managing PD patients should treat RKF preservation as an active, ongoing goal — minimizing glucose exposure, optimizing volume and blood pressure, and using RAAS blockade and biocompatible solutions in combination rather than in isolation. Digital monitoring tools may help individualize and proactively adjust PD prescriptions over time."}},{"doi":"10.1007/s00467-025-07082-9","pmid":"41526758","title":"Dialysis modality and mortality of the Contemporary Infant and Neonatal Dialysis (COINED) Cohort: a Pediatric Nephrology Research Consortium (PNRC) study","journal_title":"Pediatric Nephrology","journal_issn":"0931-041X","published_at":"2026-01-13T00:00:00.000Z","url":"https://doi.org/10.1007/s00467-025-07082-9","source_score":9,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-13","doi":"10.1007/s00467-025-07082-9","days":"7","issn":"0931-041X","rank":"6","field":"Clinical Medicine","score":"9","category":"Urology & Nephrology","categories":["Urology & Nephrology"],"_categories":["Urology & Nephrology"]},"pubmed":{"doi":"10.1007/s00467-025-07082-9","title":"Dialysis modality and mortality of the Contemporary Infant and Neonatal Dialysis (COINED) Cohort: a Pediatric Nephrology Research Consortium (PNRC) study.","journal":"Pediatric nephrology (Berlin, Germany)","methods":"","results":"For the 405 neonates in this cohort, AKI-D (57%) was the most common dialysis-related diagnosis, followed by CKD 5 (29%) and hyperammonemia (11%). Most neonates (58%) had a birth weight between 2500 and 3500 g. The most common initial neonatal dialysis modality was continuous kidney replacement therapy (CKRT) with (35%) or without extracorporeal membrane oxygenation (ECMO) (36%). Only 26% of neonates received peritoneal dialysis (PD) as their initial dialysis modality. Thirty percent of neonates received more than one dialysis modality. The overall mortality was 50% (59% in AKI-D and 41% in CKD 5). Withdrawal of care was reported as the most common reason for death. The odds of death were lower for neonates with AKI-D receiving PD as the initial modality when compared to CKRT (aOR 0.28, 95% CI 0.09-0.84) or CKRT with ECMO (aOR 0.24, 95% CI 0.10-0.58), but this association was not seen in neonates with CKD 5.","abstract":"$31","keywords":["AKI","CKRT","Neonatal dialysis","Peritoneal dialysis","Stage 5 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Disease","value_numeric":null},{"paper_doi":"10.1093/ckj/sfaf343","tag_type":"condition","value":"Hyperkalemia","value_numeric":null},{"paper_doi":"10.1093/ckj/sfaf343","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1093/ckj/sfaf343","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1093/ckj/sfaf343","tag_type":"modality","value":"Hemodialysis","value_numeric":null},{"paper_doi":"10.1093/ckj/sfaf343","tag_type":"modality","value":"Peritoneal Dialysis","value_numeric":null},{"paper_doi":"10.1093/ckj/sfaf343","tag_type":"sample_size","value":"n=82","value_numeric":82},{"paper_doi":"10.1093/ckj/sfaf343","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1093/ckj/sfaf343","tag_type":"warning","value":"Design classified as a prospective cohort based on the description in the abstract.","value_numeric":null},{"paper_doi":"10.1093/ckj/sfaf343","tag_type":"warning","value":"Modality assignment was non-random and may confound comparisons.","value_numeric":null},{"paper_doi":"10.1093/ckj/sfaf343","tag_type":"warning","value":"Only abstract-level details were available in the provided text; no numeric effect sizes or time-to-reduction data were reported.","value_numeric":null}],"summaries":{"what_studied":"Prospective single-center cohort of dialysis-naïve inpatients with incident ESKD and severe hyperkalemia (>6.5 mEq/L) admitted 2022–2024, comparing urgent-start hemodialysis versus peritoneal dialysis for potassium lowering during hospitalization. Groups: PD n=34, HD n=37, and a conservative management group n=11; baseline characteristics were reported as similar.","key_result":"PD and HD achieved comparable serum potassium reduction trajectories and similar clinical outcomes during hospitalization.","limitations":"Non-randomized modality choice by treating clinicians introduces selection bias; single-center design limits generalizability; small sample size (n=82).","practice_takeaway":"For hospitalized incident ESKD with severe hyperkalemia, urgent-start peritoneal dialysis is a reasonable alternative to hemodialysis for potassium control when initiating KRT."}}],"initialOffset":7,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Peritoneal Dialysis"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Peritoneal Dialysis"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Peritoneal Dialysis"}}}]]

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