The #PDExchange Podcast

Exercise and Peritoneal Dialysis: Enhancing Patient Quality of Life In this episode of the PD Exchange, hosts Dr. Nikhil Shah and Dr. Jeff Perl discuss the crucial topic of exercise and its impact on peritoneal dialysis (PD) patients. The discussion features a panel of experts including Dr. Stephanie Thompson, Dr. Clara Bohm, and Dr. Paul Bennett. They delve into the importance of tailored exercise interventions for improving patients' physical and mental health, overcoming barriers to activity, and implementing feasible exercise programs within PD care. Key issues addressed include swimming, lifting weights, and the benefits of prehabilitation. The conversation underscores the necessity of making exercise a fundamental component of PD treatment and calls for more research and better resources to support this cause. 00:00 Introduction and Host Welcome 00:59 Introducing the Expert Panel 02:20 Discussion on Exercise Guidelines for PD 05:02 Research and Evidence on Exercise Benefits 08:16 Challenges and Solutions in Prescribing Exercise 13:46 Types of Exercise and Their Impact 16:51 Practical Advice and Patient Motivation 26:19 Swimming and PD: Guidelines and Considerations 30:32 Debating Swimming with PD Catheters 32:22 Covering and Caring for Catheters 34:00 Scuba Diving with PD Catheters 34:49 Swimming and Daily Exercise with PD 36:31 Lifting and Exercise Guidelines 42:00 Prehabilitation and Exercise Programs 43:24 Resources and Patient Education 51:56 Future Research and Final Thoughts Links to Exercise Resources - 1. GREX Guidelines and Home page - https://grexercise.arizona.edu/ 2. Kidney health Manitoba - https://www.kidneyhealth.ca/living-with-kidney-disease/fitness-wellness/

Celebrating Women in Peritoneal Dialysis In this special episode of the PD Exchange, hosts Dr. Nikhil Shah and Dr. Jeff Perl celebrate International Women's Day by highlighting three extraordinary female nephrologists from around the world: Dr. Anabela Guedes from Portugal, Dr. Yeoung Jee Cho from Australia, and Dr. Annie-Claire Nadeau-Fredette from Canada. These leading women in peritoneal dialysis share their inspiring personal and professional journeys, discuss their challenges, and reflect on the importance of mentorship and work-life balance. The episode delves into their motivations, the impact of gender biases in the field, and the unique ways they manage their demanding careers alongside family responsibilities. It concludes with valuable advice for future women nephrologists and a discussion on the rewarding nature of working in nephrology and in peritoneal dialysis. 00:00 Introduction to the PD Exchange Podcast 00:45 Celebrating Women in Peritoneal Dialysis 01:49 Meet the Extraordinary Women in PD 02:10 Anabela's Journey into Nephrology 07:14 Yeoungjee's Path to PD 09:34 Annie Claire's Story and Balancing Family 12:09 Balancing Career and Family 19:23 Job Sharing and Work-Life Balance 28:04 Balancing Career and Family 28:56 Challenges of Managing a Busy Life 33:45 Experiencing Sexism in the Workplace 39:11 Reflections and Advice 43:51 The Rewards of Nephrology 47:34 Conclusion and Final Thoughts Women in PD - Part 1 Link https://open.spotify.com/episode/2LhdzRkp0mvHuLM8gc5cOF?si=xgJVmPCiQmSkSTBun9Sn0w

Women in PD: Venus envy? Celebrating Women in Peritoneal Dialysis: Inspiring Careers in PD   In this special episode of the PD Exchange podcast, hosts Dr. Nikhil Shah and Dr. Jeff Perl commemorate International Women's Day and InternationalDay of Women and Girls in Science, focusing on women in Peritoneal Dialysis. Joined by Dr. Joanne Bargman, Dr. Edwina Brown, and Dr. Ana Elizabeth Figueredo, the discussion dives into their extraordinary career trajectories, challenges faced as women in a predominantly male profession, and their significant contributions to peritoneal dialysis. The conversation covers themes of mentorship, overcoming gender biases, balancing family and career, and the evolving role of women in nephrology. The episode is both informative and engaging, offering valuable insights and advice for aspiring professionals in the field.   00:00 Introduction to the PD Exchange Podcast 00:25 Celebrating Women in Peritoneal Dialysis 01:34 Ana's Journey in PD Nursing 09:54 Joanne's Career in Peritoneal Dialysis 16:01 Edwina's Path to Nephrology 23:56 Balancing Family and Career 28:30 Changes and Challenges in Nephrology 39:01 Final Thoughts and Reflections  

In the first PD Exchange podcast episode of 2025, Dr. Nikhil Shah and Dr. Jeff Perl introduce a groundbreaking topic—the ELIXIR trial to evaluate Xylocore, an innovative glucose-sparing solution for peritoneal dialysis. They are joined by experts Dr. Arduino Arduini and Dr. Richard Corbett, who delve into the formulation, rationale, and design of Xylocore, detailing the incorporation of xylitol and carnitine to optimize dialysis outcomes while minimizing glucose exposure. The discussion covers the scientific, clinical, and logistical aspects of the ongoing phase three trial, implications for diabetic patients, and future research directions, emphasizing the potential cardiometabolic benefits and improved patient engagement in PD therapy. 00:00 Introduction to the PD Exchange Podcast 00:54 Meet the Experts: Dr. Arduino Arduini and Dr. Richard Corbett 03:01 The Genesis of Xylocore: A Revolutionary PD Solution 12:11 Clinical Trials and Research Insights 28:05 Patient Engagement and Future Research Directions 33:12 Conclusion and Final Thoughts PDI Original Article: Rationale and design of ELIXIR, a randomized, controlled trial to evaluate efficacy and safety of XyloCore, a glucose-sparing solution for peritoneal dialysis Mario Bonomini Simon Davies Werner Kleophas Mark Lambie Gianpaolo Reboldi Lorenzo Di Liberato Josè Carolino Divino-Filho Olof Heimburger Alberto Ortiz Johan Povlsen Massimo Iacobelli Tommaso Prosdocimi Arduino Arduini PDI Editorial : Will Xylocore® be the magic ELIXIR for peritoneal dialysis? Johann Morelle Carl M. Öberg

Welcome to another episode of the PD Exchange with your host Dr Nikhil Shah and your co-host Dr Jeff Perl. Today, we discuss the newly released Clinical Practice Guideline for the Prevention and Management of Peritoneal Dialysis-Associated Infections in Children. Drs Brad Warady, Claus Schmitt, Rebecca Same, and Brandy Begin RN discuss these guidelines and the changes from the previous ones! Enjoy!

Drs Jeff Perl and Nikhil Shah discuss the latest ISPD position paper on Assisted PD with Drs Matthew Oliver (Toronto, Canada), Thierry Lobbedez (Caen, France), and Janet Graham RN (Ottawa, Canada). Enjoy a wide-ranging discussion that covers everything from why Assisted PD is important to how a new program can start considering planning and implementing it. Open Access Paper - Assisted peritoneal dialysis: Position paper for the ISPD - Matthew J Oliver, Graham Abra, Clémence Béchade, Edwina A Brown, Ana Sanchez-Escuredo, David W Johnson, Anabela Malho Guedes, Janet Graham, Natalia Fernandes, Vivekanand Jha, Nadia Kabbali, Talerngsak Knananjubach, Philip Kam-Tao Li, Ulrika Hahn Lundström, Page Salenger, Thierry Lobbedez, 2024 (sagepub.com) Comments, suggestions? Please reach out to us on X/Twitter - @pdi_journal, @dr_nikhilshah, @PD_Perls Email - pdi.journal@gmail.com

Drs Jeff Perl (@PD_Perls) and Nikhil Shah(@dr_nikhilshah), are joined by the creator of NephMadness Dr Matthew Sparks (@NephroSparks) and Nephrology fellow from Duke University Dr Tim Hopper to discuss the Peritoneal Dialysis Teams in Nephmadness. The competition - Team 1 - PD First vs Team 2 - Beyond kt/v Links - AJKD Blog Nephmadness PD Region Page #NephMadness

Drs Jeff Perl and Nikhil Shah chat with PD Access royalty Dr. John Crabtree and Dr. Matthew Oliver. They discuss the recent publication in PD International regarding PD Access success in Japan, referencing the Japanese program to train nephrologists at this skill by practicing on chickens!! A multi-institutional, observational study of outcomes after catheter placement for peritoneal dialysis in Japan. Sakudara et al. ⁠https://journals.sagepub.com/doi/abs/10.1177/08968608231193240⁠ Multi-institutional audit of outcomes after peritoneal dialysis catheter placement in Japan: What are the takeaways? John Crabtree ⁠https://journals.sagepub.com/doi/abs/10.1177/08968608231210127⁠ Please email your comments and suggestions to pdi.journal@gmail.com or tag us on X/Twitter @dr_nikhilshah or @PD_Perls.

Drs Jeff Perl and Nikhil Shah, welcome you to the 8th episode of PD Exchange. (on a side note - we now have >1000 plays and are listed by FEEDSPOT among the top 10 dialysis podcasts on the web! - thanks to YOU, our listeners) This episode is a gem! We are grateful to Prof. Edwina Brown (ISPD President) and A/Prof Yeoung Jee Cho (PDI Deputy Editor in Chief), along with author Dr. Melissa Cheetham, for coming together to discuss the many facets of the patient-centred INCREMENTAL PD or more like PERSONALIZED PD as Prof Brown calls it. The September issue of PDI has four articles on Incremental PD - 2 editorials and two studies. Current PDI Issue - https://bit.ly/PDICurrent Links to the articles - Incremental peritoneal dialysis: Incremental gains Incremental peritoneal dialysis: ‘I am lucky to only be doing two exchanges’ Association of Incremental peritoneal dialysis with residual kidney function decline in patients on peritoneal dialysis: The balANZ trial Multicentre registry analysis of incremental peritoneal dialysis incidence and associations with patient outcomes For feedback, comments, questions and suggestions - please email nshah1@ualberta.ca

Welcome to the Peritoneal Dialysis International Abstract Podcast. Here, we are trying to bring the Table of Contents and the Abstracts from the most recent issue of Peritoneal Dialysis International. We have tried to use AI-generated speech from the abstracts. We have made minor changes to the abstracts to make listening easier. We would love to get feedback on this format of receiving PDI highlights. Current Issue Link - bit.ly/PDICurrent Feedback - Nikhil Shah - nshah1@ualberta.ca

Your hosts Nikhil and Jeff discuss the PD catheter-related infection recommendations with Prof KM Chow and Prof David Johnson the lead authors for these recommendations. Both authors provide deep insight and rationale behind the suggestions and guidance on managing this common problem. Full text #OpenAccess - https://journals.sagepub.com/doi/full/10.1177/08968608231172740 Accompanying Editorials - Caring for the peritoneal dialysis catheter: Reflections on catheter and exit site care in peritoneal dialysis - Brad Rossiter, Chandana Guha, and Karine Manera - https://journals.sagepub.com/doi/abs/10.1177/08968608231172903 Reducing and treating peritoneal dialysis catheter-related infections: Nursing implementation from evidence to practice. - Ana E Figueiredo and Gillian Brunier. - https://journals.sagepub.com/doi/abs/10.1177/08968608231172912 For any questions, comments or suggestions - please reach out to us on Twitter - Nikhil (@dr_nikhilshah) Jeff (@PD_Perls) or email : nshah1@ualberta.ca

Drs Oberg and Fraser along with Drs Perl and Shah discuss the exciting experiments regarding Phloretin (a GLUT blocker derived from apples!) and Phlorizin (a SGLT2 and SGLT1 blocker) and its potential use in Peritoneal Dialysis.  PDI paper link - Dual SGLT1/SGLT2 inhibitor phlorizin reduces glucose transport in experimental peritoneal dialysis - Giedre Martus, Karin Bergling, Carl M Öberg, 2022 (sagepub.com) JASN paper link - Phloretin Improves Ultrafiltration and Reduces Glucose Absor... : Journal of the American Society of Nephrology (lww.com) Questions of suggestions please reach out to Drs Nikhil Shah (https://twitter.com/dr_nikhilshah)  and Jeff Perl (https://twitter.com/PD_Perls) via Twitter or write to nshah1@ualberta.ca

Outcomes of PD for AKI treatment during COVID-19 in New York City: A multicenter study Drs Maryann Sourial and Wei Chen discuss their experience of starting an acute PD program for AKI in New York at the height of the pandemic dealing with the massive patient influx and limited resources.  For any questions, suggestions tweet us at - Nikhil Shah (@dr_nikhilshah) and Jeff Perl (@PD_Perls) or email us at nshah1@ualberta.ca

Karine Manera (@KarineManera), Associate Editor for Peritoneal Dialysis International (@PDI_Journal) and patient partner Annette Spence join the #PDExchange hosts Nikhil Shah (@dr_nikhilshah) and Jeff Perl (@PD_Perls) to discuss #LifeParticipation in patients on PD which is a core outcome identified by the SONG-PD initiative (@SONG_Initiative).  Paper: Establishing a core outcome measure for life participation in patients receiving peritoneal dialysis: A Standardised Outcomes in Nephrology–Peritoneal Dialysis consensus workshop report - Melissa S Cheetham, Martin Wilkie, Fiona Loud, Karine E Manera, Angela Ju, Ana Figueiredo, Janine Farragher, Helen Hurst, Sarbjit V Jassal, Rajnish Mehrotra, Rachael L Morton, Daniel Schwartz, Jenny I Shen, Rachael Walker, Yeoungjee Cho, David W Johnson, Jonathan C Craig, Samaya Anumudu, Amanda Baumgart, Andrea Matus Gonzalez, Nicole Scholes-Robertson, Andrea K Viecelli, Allison Tong, On behalf of the SONG-PD Life Participation Workshop Investigators, On behalf of the SONG-PD Life Participation Workshop Investigators, 2022 (sagepub.com)

PDExchange 002 Episode Details  At the start, Dr. Jeff Perl the Editor in Chief and Dr. Yeoungjee Cho, the Deputy Editor in Chief for Peritoneal Dialysis International, share some insight behind the editorial process for PDI. They discuss the process of selecting papers for publication in PDI and also provide some tips for researchers in the Peritoneal Dialysis world and invite them to submit their work to PDI.  Next, we have a series of papers #EditorsChoice that Drs Perl and Cho briefly discuss.  The links to the respective papers are listed below –  Outcome measures for technique survival reported in peritoneal dialysis: A systematic review  Four steps to standardize reporting of peritoneal dialysis technique failure: A proposed approach  Growing home dialysis: The Ontario Renal Network Home Dialysis Initiative 2012–2019  Overcoming barriers and building a strong peritoneal dialysis programme – Experience from three South Asian countries  Burden of kidney disease among patients with peritoneal dialysis versus conventional in-centre haemodialysis: A randomised, non-inferiority trial  Patient and caregiver perspectives on burnout in peritoneal dialysis  Assisted peritoneal dialysis across Europe: Practice variation and factors associated with availability  Flexibility in peritoneal dialysis prescription: Impact on technique survival  Incremental peritoneal dialysis in incident end-stage kidney disease patients

Abstract Background: Providing support is important to maintain a patient on peritoneal dialysis (PD), though its impact on outcomes has not been investigated thoroughly. We examined the association between having support and risk of a transfer to hemodialysis. Methods: In this retrospective observational cohort study, we used data captured in the Dialysis Measurement Analysis and Reporting system about patients who started PD in Alberta, Canada, between 1 January 2013 and 30 September 2018. Support was defined as the availability of a support person in the home who was able, willing and available to provide support for PD in the patient’s residence. The outcome of interest was a transfer to hemodialysis for at least 90 days. We estimated the cumulative incidence of a transfer over time accounting for competing risks and hazard ratios to summarise the association between support and a transfer. We split follow-up time as hazard ratios varied over time. Results: Six hundred and eighty-three incident PD patients, median age 58 years (IQR: 47–68) and 35% female, were followed for a median of 15 months. The cumulative incidence of a transfer to hemodialysis at 24 months was 26%. Having support was associated with a reduced risk of a transfer between 3 and 12 months after the start of dialysis (HR3-12mo: 0.44; 95% CI: 0.25–0.78), but not earlier (hazard ratio (HR)<3mo: 0.96; 95% confidence interval (CI): 0.55–1.69) or later (HR>12mo: 1.19; 95% CI: 0.65–2.17). Conclusions: A transfer to hemodialysis is common. Having a support person at home is associated with a short-term protective effect after the initiation of PD.