Arsh Jain

Arsh Jain

Researchers developed and tested computer models using health records from people with chronic kidney disease in Taiwan and the United States to predict rapid worsening or the need for kidney replacement therapy. The models performed consistently across the groups, and an explanation tool showed which patient information influenced each prediction, offering a potential way to support future clinical use.

Arsh Jain

This review outlines ways to address problems with peritoneal dialysis catheters, from treating reversible causes such as constipation or material blocking the tube to image-guided procedures or surgery. It stresses that the key goal is a lasting return to the planned dialysis routine, not simply restoring the catheter’s position, while avoiding temporary blood-based dialysis, repeat emergency visits, and preventable treatment failure.

Arsh Jain

Researchers reviewed 1,537 people who received a peritoneal dialysis catheter to see whether kidney function at insertion was related to complications. Overall, complication rates were similar for those above and below the study’s kidney-function cutoff, but among patients below it, lower kidney function was linked to greater risk; starting dialysis within 30 days of insertion was also linked to more complications. Because this was an observational study, the findings show associations and do not establish that changing the timing would prevent complications.

Arsh Jain

Eleven people receiving peritoneal dialysis tracked symptoms during their usual treatment and during a seven-day trial of a wearable dialysis device, and took part in interviews about their experience. They reported fewer symptoms during device use, with some noting improvements in itching, sleep, and pain, but the small group and short trial cannot establish whether the device is better than usual treatment.

Arsh Jain

Researchers tested whether a home system could evenly mix a 15-litre peritoneal dialysis solution within a practical time. Mixing for 30 or 40 minutes generally produced consistent glucose and sodium levels throughout the bag, while 25 minutes did not; the results support the system’s feasibility, though the effects of water temperature and solution strength on mixing time remain to be assessed.

Arsh Jain

Researchers tested the final filter in a system designed to produce water for home peritoneal dialysis, including tests using water with high levels of bacterial toxins. In all five tests, toxin levels after filtration were below the test’s detection limit, but the study assessed only this filter—not the full system or its ability to maintain water quality over time.

Arsh Jain

Researchers compared the amount of dialysis fluid prescribed with the amount delivered to 13 people receiving automated peritoneal dialysis over three months. The quantities often differed, with some months bringing excess supplies and others too little, suggesting that better coordination of prescribing, ordering, and delivery could reduce waste and make supplies more responsive to patients’ needs.

Louise MoistArsh Jain

This narrative review examined factors contributing to obesity among Indigenous Peoples in Canada and their implications for kidney health. It describes how food insecurity, social and economic inequities, cultural disruption, historical trauma, racism, and barriers to culturally safe care may contribute to obesity and chronic kidney disease. The authors highlight community-led approaches to improve food security and access to culturally appropriate obesity care.

Louise MoistArsh JainDanielle NashAmit Garg

A large Ontario study examined adults with a dangerously high potassium level measured outside hospital. Compared with similar people who did not go to an emergency department, those who went within 24 hours had lower death rates over the next one, three, and seven days, especially when potassium was very high or kidney function was poor; this supports urgent emergency assessment.

Arsh Jain

A multi-national survey of peritoneal dialysis unit staff in Australia, Canada, and Thailand revealed that incremental peritoneal dialysis is prescribed infrequently and defined inconsistently across centres. While clinicians noted benefits such as improved patient satisfaction and preservation of remaining kidney function, they also identified challenges, including patient resistance to future dose increases and the need for closer monitoring. The findings highlight a lack of international consensus and a need for clearer guidance on how to safely prescribe and manage this treatment approach.

Arsh Jain

This laboratory study evaluated whether a new automated peritoneal dialysis connector design could better prevent bacterial contamination compared to existing connectors. Researchers simulated touch contamination with bacteria on three different dialysis systems and found that connectors with bilateral shrouded, recessed fluid paths significantly reduced bacterial transfer into the dialysis fluid. This design has the potential to lower the risk of peritoneal dialysis-related peritonitis, though clinical studies in patients are needed to confirm these findings.

Arsh Jain

This single-centre feasibility study tested a smartphone app and web portal that allowed people with chronic kidney disease or those receiving peritoneal dialysis to record health information and monitor treatment remotely. Among the 27 participants who completed follow-up, 56% used the app often enough to meet the study’s acceptance target, with higher acceptance among those with chronic kidney disease than among those receiving peritoneal dialysis. Interviews identified communication, convenience, and clarity as important factors, supporting improvements such as two-way clinician communication, simpler data entry, and better integration into routine care.

Arsh Jain

The Kidney Check program was implemented across five Canadian provinces to provide community-led, culturally safe, and mobile point-of-care screening for chronic kidney disease, diabetes, and hypertension in Indigenous communities. Screening thousands of participants across more than fifty communities proved feasible and acceptable, successfully identifying individuals at intermediate and high risk for kidney disease. Key facilitators for success included strong community partnerships and local hiring, though challenges remain regarding staffing constraints, logistics, and long-term funding sustainability.

Arsh Jain

Kidney Check is a community-based program that began in Manitoba to support early detection and management of chronic kidney disease in Indigenous communities. After initial success, it was integrated into a national kidney research network to strengthen Indigenous leadership and coordinate expansion across provinces, with a focus on addressing barriers to screening in remote and underserved areas.

Christopher McIntyreArsh Jain

Researchers used brain scans and thinking tests to follow 14 people receiving hemodialysis or peritoneal dialysis for one year. Signs of injury to the brain’s connecting tissue worsened in all eight people receiving hemodialysis and one of six receiving peritoneal dialysis, but thinking-test scores did not change significantly.

Arsh JainDanielle NashAmit GargPeter Blake

Researchers evaluated the impact of changing the eligibility rules for multidisciplinary kidney care in Ontario, Canada, which shifted from a simple kidney function threshold to a risk-based model. While the change led to fewer patients receiving specialized clinic care and a slight increase in late referrals before starting dialysis, there were no significant negative effects on long-term clinical outcomes like dialysis initiation methods or mortality. These findings suggest that using risk-based criteria can help focus resources on high-risk patients without compromising overall patient safety.

Christopher McIntyreArsh Jain

This study used advanced brain imaging and cognitive testing to examine how peritoneal dialysis affects the brain compared to the known risks of hemodialysis. Researchers found that while patients on peritoneal dialysis experienced significant increases in brain glucose levels during treatment, they did not show the acute signs of restricted blood flow or brain injury typically seen in hemodialysis patients. Despite this protective effect on brain structure, many participants still demonstrated difficulties with memory, attention, and executive function during cognitive assessments.

Arsh Jain

This article considers whether digital tools that track people receiving peritoneal dialysis at home help them stay on that treatment longer. The authors conclude that current evidence does not show that remote monitoring prevents a switch to hemodialysis, and argue that collecting information alone may not help unless care teams have clear processes for responding promptly.

Arsh Jain

Researchers compared usual peritoneal dialysis with a new device that repeatedly refreshes the dialysis fluid in 11 people with kidney failure. During the short treatment period, participants stayed within 5% of their target weight, while the device achieved fluid removal with less glucose exposure than usual treatment. These findings suggest the approach may reduce glucose exposure during dialysis, but long-term effects were not assessed.

Arsh Jain

This review examines the significant health disparities and high rates of chronic kidney disease faced by approximately 480 million Indigenous people worldwide due to the ongoing impacts of colonialism, systemic racism, and poverty. The authors describe how geographic isolation and a lack of culturally safe care create barriers to early detection and life-saving treatments like dialysis or transplantation. The publication provides policy recommendations and strategies for healthcare systems to deliver more responsive, equitable kidney care to Indigenous communities across the globe.

Arsh Jain

This protocol describes an ongoing study to determine if a virtual monitoring platform can reduce emergency department visits and hospitalizations for patients with advanced chronic kidney disease. Participants in the intervention group use wireless devices to track blood pressure, weight, and oxygen levels, while also completing weekly symptom surveys through a mobile tablet. The study aims to improve the safety and coordination of care during the high-risk period before a patient begins dialysis.

Arsh Jain

Researchers assessed how a wearable device that cleans and reuses dialysis fluid removes urea, a waste product, during peritoneal dialysis. In measurements from 12 people, urea levels in fluid leaving the abdomen during treatment were lower than in the final drainage, suggesting that the usual calculation based on the final drainage may give an inaccurate estimate of dialysis delivered; the researchers proposed a separate calculation and noted that urea clearance alone does not capture overall dialysis quality.

Arsh Jain

Researchers tested connection pieces used for automated peritoneal dialysis in a laboratory simulation where one side of the connection was exposed to bacteria. Fluid samples from systems with covered tubing connectors showed no bacterial growth, while the uncovered system had heavy growth; this suggests the new design could reduce contamination, but patient infections were not studied.

Arsh Jain

Researchers tested a system that makes fluid for dialysis through the abdomen from tap water as needed in one pig with kidney failure. During 14 days of use, tests found the fluid was sterile with very low levels of bacterial toxins, and the pig’s blood and drained-fluid measures stayed stable with no signs of infection. These early results suggest the approach was tolerated in this animal over the short term, but do not establish safety in people.

Arsh Jain

Researchers tested and adjusted two artificial intelligence tools designed to predict kidney failure or rapid loss of kidney function, using health records from more than 230,000 people with chronic kidney disease at Mayo Clinic sites. The tools remained accurate even when nearly half of the information was missing and performed better than an existing risk calculator; adjusting them with local data worked about as well as rebuilding them, which could make them easier to use at other sites.

Arsh Jain

This review examines the development of sorbent peritoneal dialysis technologies, which are portable or wearable devices designed to clean and reuse dialysis fluid. Researchers evaluated five different systems, finding that several could effectively remove waste products like urea and creatinine in human or animal trials, often using less sugar to achieve fluid removal than standard dialysis. While these technologies offer the potential for increased patient mobility and more efficient treatment, their specific role as either a supplement to or a replacement for traditional peritoneal dialysis is still being determined.

Louise MoistArsh JainDanielle NashAmit Garg

Researchers analyzed over 65 million potassium measurements in Ontario and found that while severe high potassium is common in outpatients, only thirteen percent of these individuals visited an emergency department within twenty-four hours. Patients who did go to the emergency department typically had more health conditions and higher medication use, and their potassium levels were significantly lower upon arrival than their initial outpatient test. Despite guidelines recommending urgent care for these high levels, most patients were managed in the community, and about one percent of the total group died within one week of the test result.

Arsh Jain

Researchers found that genetic factors account for approximately half of the individual variation in how effectively peritoneal dialysis removes excess fluid from the body. By analyzing the genomes of over 2,700 participants, the study identified several specific genes associated with fluid removal and used mouse models to demonstrate how one of these genes regulates the process. These findings help explain why some patients respond differently to peritoneal dialysis and identify potential biological pathways for improving treatment.

Christopher McIntyreArsh Jain

Patients receiving maintenance dialysis often experience faster and more severe cognitive decline compared to those with advanced kidney disease who are not on dialysis. This review explores how both hemodialysis and peritoneal dialysis can cause structural and functional brain changes, leading to symptoms ranging from short-term confusion and brain fog to long-term loss of cognitive ability. The authors examine the underlying biological mechanisms of this decline and discuss potential medical interventions to protect brain health in this population.

Louise MoistDervla ConnaughtonMatthew WeirSusan HuangAndrew HouseLakshman GunaratnamArsh JainAmit GargAndrea CowanPavel RoshanovPeter Blake

In a study of 125 adults aged 50 and older with chronic kidney disease, researchers found that genetic testing identified a specific cause of disease in 38% of patients. The highest success rate for diagnosis occurred in those aged 50 to 54, with various forms of glomerular disease being the most common findings. These genetic results led to changes in medical treatment and clinical management, suggesting that age alone should not be a barrier to accessing genetic testing for kidney disease.

Louise MoistDervla ConnaughtonMatthew WeirSusan HuangAndrew HouseLakshman GunaratnamArsh JainAndrea CowanPavel Roshanov

Researchers evaluated the impact of a specialized kidney genetics clinic in Canada by providing genetic testing to 300 patients with chronic kidney disease who met specific referral criteria. The study found that using a standardized testing process identified a genetic cause for kidney disease in one-third of the families, with results typically delivered within three months of assessment. These genetic findings frequently led to changes in clinical management, though the researchers noted a significant delay of over ten years between a patient's initial kidney disease diagnosis and their eventual genetic evaluation.

Arsh Jain

In an international consensus workshop involving patients, caregivers, and health professionals, researchers sought to standardise how the success of peritoneal dialysis is measured and reported. The participants recommended replacing negative terms like "technique failure" with neutral language such as "transfer to haemodialysis" to better reflect the patient experience. This report proposes a clear, consistent definition for this outcome to ensure that future clinical trials can be easily compared and remain relevant to both patients and clinicians.

Arsh Jain

This case report describes the successful management of a patient who required a colostomy while receiving peritoneal dialysis for kidney failure. Although intestinal stomas are sometimes considered a risk for dialysis complications like infection, placing the stoma and the dialysis catheter on opposite sides of the abdomen allowed the patient to continue his treatment safely. The procedure improved the patient's independence and quality of life without causing major complications during follow-up.

Susan HuangArsh Jain

In this phase 2 clinical trial, researchers tested whether ravulizumab, a medication that blocks a specific part of the immune system called the complement system, could help adults with IgA nephropathy. Patients receiving ravulizumab experienced a 30% greater reduction in protein leakage in their urine compared to those receiving a placebo after six months of treatment. The medication was well tolerated, with safety results similar to the placebo group, and showed potential in helping to stabilize kidney function.

Arsh Jain

Researchers compared two schedules for giving glucose during treatment with an automated peritoneal dialysis device in a pig model. Both schedules removed similar amounts of fluid, but giving glucose every 15 minutes achieved this with less glucose exposure, suggesting a more efficient prescription; the findings come from an animal experiment and do not show how well the approach works in people.

Arsh Jain

In a small early study, 11 adults tried a wearable machine for home dialysis for one week, and three continued for up to a month. Most planned treatments were completed, participants stayed close to their target weight, and no serious problems were linked to the device; the three who continued for a month reported less disruption to daily life, though this finding is based on only three people.

Arsh Jain

Researchers tested a kidney-risk prediction tool developed in Taiwan using data from 4,465 people with chronic kidney disease in the United States to estimate who would need dialysis or a kidney transplant. Its predictions were generally accurate across racial groups and especially reliable at identifying people unlikely to need these treatments, although predictions for the highest-risk group varied. There was not enough information to fully test the tool’s separate model for rapid disease progression, so the findings support one part of the tool for risk assessment in a broader population.

Arsh Jain

This commentary discusses two new studies that challenge the traditional practice of waiting two weeks after catheter insertion before starting peritoneal dialysis. The research demonstrates that while starting dialysis urgently may lead to more frequent minor fluid leaks, these leaks do not negatively impact long-term patient survival, infection rates, or the overall success of the dialysis technique. These findings suggest that peritoneal dialysis is a safe and effective option for patients who need to begin treatment immediately, potentially avoiding the need for temporary hemodialysis.

Christopher McIntyreArsh Jain

This pilot study used advanced sodium magnetic resonance imaging to evaluate the kidney's tubular function in patients undergoing peritoneal dialysis compared to those on hemodialysis. Although peritoneal dialysis patients typically maintain higher urine volumes, the imaging revealed that both groups had similarly reduced levels of tubular function, specifically in their ability to concentrate urine. These findings suggest that measuring urine volume alone provides an incomplete picture of residual kidney health in dialysis patients.

Arsh Jain

This study is assessing whether people with chronic kidney disease, including those receiving peritoneal dialysis, find a smartphone application acceptable and easy to use. The application is intended to help track vital signs, eating habits, medication use, and dialysis information, but the description does not report study findings.

Arsh Jain

Researchers describe developing an artificial intelligence tool to estimate how kidney disease may worsen in people with advanced chronic kidney disease. It is intended to help care teams discuss what to expect, consider medicines that protect kidney function, and plan for dialysis or a kidney transplant; the abstract does not report the tool’s accuracy or results from its use in practice.

Arsh Jain

Researchers examined data from over 800 patients in Canada and the United States to determine if previous abdominal surgeries affected the success of peritoneal dialysis catheters. The study found that a history of prior abdominal procedures did not increase the risk of catheter failure or complications, although surgeries in the upper abdomen were associated with a slightly higher risk of issues. These findings suggest that having had abdominal surgery in the past should not prevent patients from being considered for peritoneal dialysis.

Arsh Jain

Researchers tracked over 700 patients undergoing laparoscopic peritoneal dialysis catheter insertion and found that those with existing internal scarring, known as adhesions, were at a higher risk for complications like flow restriction or abdominal pain. While patients with adhesions were more likely to require follow-up procedures to fix catheter issues, the majority of patients in both groups were still able to successfully continue their dialysis therapy. The study identified that previous abdominal surgery, female sex, and higher body mass index were factors associated with a higher likelihood of having these adhesions.

Arsh Jain

Researchers reviewed records and X-ray images from 286 adults starting peritoneal dialysis to find out whether the catheter’s final position in the pelvis could predict early problems with fluid flow. Catheter position was not linked to dysfunction within three months; among the factors assessed, higher body mass index (a measure based on weight and height) was the only one associated with dysfunction after adjustment.

Christopher McIntyreArsh Jain

Researchers tested thinking skills and used brain scans in 12 people receiving peritoneal dialysis, before and after a 90-minute period with dialysis fluid in the abdomen. Many participants had difficulties with attention and other thinking skills; scans showed no short-term injury to the brain’s communication pathways, although brain sugar levels increased. The findings suggest no immediate brain injury during this treatment in this small group, but do not show what happens over time.

Arsh Jain

Researchers analyzed registry data from Australia and New Zealand and found that the use of incremental peritoneal dialysis, which involves a lower initial dose of dialysis fluid, increased significantly between 2007 and 2017. The study found that starting with a lower dose was not associated with an increased risk of death and was linked to a lower rate of early transfer to hemodialysis. These findings suggest that incremental peritoneal dialysis is a safe approach that may reduce treatment burden for patients who still have some remaining kidney function.

Arsh JainPeter Blake

Researchers evaluated a modified, low-dose regimen of the antiviral medication nirmatrelvir/ritonavir in 134 dialysis patients with COVID-19 in Ontario, Canada. The study found that the treatment was safe and well-tolerated, with 96% of patients completing the full course and no COVID-19-related deaths occurring within 30 days. While many patients required adjustments to their other medications due to drug interactions, this modified dosing provides a potential treatment option for a high-risk group originally excluded from clinical trials.

Louise MoistArsh JainAmit Garg

This narrative review examines the difficulties in managing high potassium levels in outpatient settings, noting that current treatment thresholds are inconsistent and often rely on individual clinical judgment. The authors highlight issues such as falsely elevated laboratory results and a lack of standardized notification systems between laboratories and healthcare providers. These inconsistencies can lead to unnecessary emergency department visits or delays in treating potentially life-threatening conditions.

Christopher McIntyreArsh JainAmit Garg

This study investigated whether tailoring the temperature of dialysis fluid to each patient's body temperature could reduce cardiovascular problems in people receiving long-term dialysis. Researchers found no significant difference in rates of cardiovascular death or hospital admission between patients receiving personalized cooler dialysis and those receiving standard temperature dialysis. The findings suggest that the widespread adoption of cooler dialysis may need to be re-evaluated, as it did not demonstrate the expected cardiovascular benefits in this large trial.

Louise MoistArsh Jain

Clinical domain: The study focuses on the recognition and management of obesity within a chronic kidney disease population. - What investigators did: The researchers performed a retrospective chart review (observational) and an online survey of nephrologists (observational/survey) to assess clinical documentation and physician perceptions. - Methodological features: The study relies on survey research and the analysis of clinical records to identify gaps in care delivery.

Arsh Jain

This review compares starting peritoneal dialysis, a treatment that uses the lining of the abdomen to filter blood, at a lower-than-standard level with starting at the usual level. It discusses possible benefits, such as less treatment burden and better preservation of remaining kidney function, as well as concerns about waste or fluid build-up, and reviews the available clinical trial evidence.