Journal Watch - Hemodialysis

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  • More Hospital Readmissions with PD Than In-Center HD

    Those on PD have fewer routine clinic visits than those on standard in-center HD. This may help explain why a 10-year study of hospital discharges among 28,026 dialyzors in Canada found that 30-day readmission rates in PD patients were higher (7.1) than for matched patients doing standard in-center HD (6.0). Better care transitions may help.

    Read the abstract » | (added 2017-02-08)

    Tags: Hemodialysis, Peritoneal dialysis

  • Does Frequent HD Boost Quality of Life? YES

    As with nearly every other study, a new paper from the Frequent Hemodialysis Network trial looked at HRQOL among patients randomized to conventional vs. 6x/week HD (N=245) or 6x/week nocturnal vs. conventional home HD (N=87). After one year, patients who dialyzed more often had higher HRQOL than those on standard HD—and shorter recovery after each treatment.

    Read the abstract » | (added 2017-02-08)

    Tags: Hemodialysis

  • Does Frequent HD Boost Quality of Life? NO

    A new Canadian study randomized 200 patients to standard in-center HD (12-15 hours/wk; maximum of 18 hours) or extended HD (>24 hours/wk) for a year. Extended HD reduced phosphate and potassium levels and boosted Hgb, and patients took fewer BP meds and phosphate binders. However, health-related quality of life scores did not differ significantly between the groups.

    Read the abstract » | (added 2017-02-08)

    Tags: Hemodialysis

  • Medicare Payment for Daily Home HD Varies Geographically

    According to Medicare claims data for in-center HD and home HD from 2009-2012, there were persistent variations in the home HD treatment claims paid by different Medicare contractors. Fortunately, these differences did not seem to affect whether clinics offered home HD.

    Read the abstract » | (added 2017-02-08)

    Tags: Hemodialysis

  • Low Molecular Weight Heparin Use in Nocturnal HD

    Since people sleep during nocturnal HD, a form of heparin with a longer half-life is needed to keep blood from clotting. Enter low molecular weight heparin (LMWH). A study in Hong Kong* randomized 12 nocturnal HD patients to receive nadroparin or unfractioned heparin for a week—and then switch. The researchers concluded that LMWH was safe and effective, though if treatments are done each night, it is important to monitor for build up of the heparin in the blood.

    Read the abstract » | (added 2017-01-09)

    Tags: Hemodialysis

  • NxStage Outcomes in France and Belgium

    Among 62 patients from 31 centers in France and Belgium, albumin and bicarbonate levels improved significantly, and technique survival was 75% at one year (most who stopped received transplants). Despite the low volume of dialysate, the rsearchers concluded that dialysis adequacy was acceptable.

    Read the abstract » | (added 2016-12-09)

    Tags: Hemodialysis

  • Systematic Review of Pregnancy on HD

    A new review summarizes 101 full papers and 25 abstracts and addresses the promise of successful pregnancy if enough HD is given.

    Read the abstract » | (added 2016-11-10)

    Tags: Hemodialysis

  • Why Seniors Choose HD vs. PD

    Older people may be equally suited for PD or HD, so what guides their choice? In an interview study, PD was selected by those wanted convenience and a normal life. HD, on the other hand, was chosen by those who were afraid and wanted security. EDITOR’S NOTE: Of course patients are afraid! We need to help ease their fears before we educate them about their options.

    Read the abstract » | (added 2016-11-10)

    Tags: Hemodialysis

  • Time Matters: HD Kt Dose , Hospitalization, and Death

    Does adding more HD benefit patients? Yes, finds a Fresenius study of 6,129 patients in Spain. There as a progressive increase in the risk of death for patients who were below the target Kt, and as Kt rose to reach and exceed the target, the risk declined, as did the risk of hospitalization. “Thus, prescribing an additional 3 L or more above the minimum Kt dose could potentially reduce mortality risk, and 9 L or more reduce hospitalization risk,” noted the authors.

    Read the abstract » | (added 2016-11-10)

    Tags: Hemodialysis

  • The HEMO Study Returns with a New Message

    “An index only on the basis of urea does not provide a sufficient measure of dialysis adequacy,” finds yet another reanalysis of the by-now-ancient HEMO study data. Looking only at small uremic solutes—even non-urea wastes—did not predict all-cause mortality. Doing HD just three times a week made it impossible to remove enough solutes to matter.

    Read the abstract » | (added 2016-11-10)

    Tags: Hemodialysis