Journal Watch - Hemodialysis

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  1. Independence, Flexibility and Quality of Life Matter to Patients

    For the PCORI-funded Empowering Patients on Choices for Renal Replacement Therapy (EPOCH-RRT), 180 people not yet on dialysis or using standard HD or PD were interviewed to identify the factors in their choice of a dialysis option. Independence, quality and quantity of life, and daily schedule flexibility mattered most—and 47% of those on standard HD said the choice had not been theirs. (NOTE: Ironically, the EPOCH-RRT decision aid omits home HD, an option that offers independence, quality of life, better survival, and schedule flexibility, as we have blogged here and here).

    Read the abstract » | (added 07/12/2016)

    Tags: Hemodialysis

  2. For HD Survival, Home Beats In-Center

    An observational study looked back at 41 incident patients starting home HD and matched them to patients starting in-center HD by sex, age, comorbidity, and start date. Mean survival on home HD was 17.3 years, vs. 13 years in-center. Home HD patients also had significantly lower phosphate levels and did not require blood pressure medications.

    Read the abstract » | (added 07/12/2016)

    Tags: Hemodialysis

  3. PD or In-Center HD: Which is Better for Transplant?

    An analysis of 12 studies found that doing PD before a transplant had significanlty less delayed graft function than those who did standard in-center HD. While on dialysis, PD had better 5-year survival than standard HD, too. There were no differences in the rates of acute rejection or transplant survival. Watch a Video Journal Club of this study on 'Cappuccino with Claudio Ronco'

    Read the abstract » | (added 07/12/2016)

    Tags: Hemodialysis

  4. Outset Medical Tablo Human Factors Testing

    Journal articles don’t tend to give product names, so we read between the lines to tell you that human factors testing on Outset’s Tablo home HD machine found 2.9 errors for patients—and 4.4 for nurses or technicians—out of 1,710 opportunities for error. None of the errors was safety related.

    Read the abstract » | (added 06/08/2016)

    Tags: Hemodialysis

  5. Patient Costs As A Challenge For Home Dialysis Choice

    Interviews with 43 home dialysis patients and 9 care partners found that fears of lost work productivity, out of pocket expenses, and socioeconomic disadvantage were challenges to choosing home dialysis. Patients weighed flexibility against training time and costs, and housing was not always suitable.

    Read the abstract » | (added 06/08/2016)

    Tags: Hemodialysis

  6. Nocturnal HD Protects Bones Better Than Standard HD

    Compared to 52 patients on conventional HD, 36 patients on nocturnal HD had better bone mineral density at the lumbar spine, femoral neck, and hip after one year.

    Read the abstract » | (added 06/08/2016)

    Tags: Hemodialysis

  7. More Inflammation With Standard HD Than With PD

    Inflammation can lead to heart damage and poor outcomes. Two 3-month prospective studies with 228 HD and 80 PD patients measured two markers of inflammation: CRP and IL-6. In HD patients, these levels were both higher and more variable than in PD.

    Read the abstract » | (added 06/08/2016)

    Tags: Hemodialysis

  8. Preliminary Data for the VasQ™ Fistula Construction Tool

    A new Israeli device (available in three sizes) has been tested in 20 patients as a way to improve fistula flow and reduce hyperplasia at the anastomosis to reduce primary fistula failure. Primary patency was assessed at 1, 3, and 6 months, and there were no device-related adverse events. At the end of the study 14 of the 15 patients who required dialysis had a working fistula.

    Read the abstract » | (added 05/12/2016)

    Tags: Hemodialysis

  9. Glycated Albumin More Accurate in PD than Glycated Hemoglobin

    Using hemoglobin A1c levels to assess glycemic control in people with diabetes using PD is risky, because anemia causes false negative results. In a 6-month study, 20 people with diabetes using HD were matched for age, sex, and post-meal glucose levels with people with diabetes using PD. In a multiple regression analysis, glycated albumin was the only independent predictor of plasma glucose levels.

    Read the abstract » | (added 05/12/2016)

    Tags: Hemodialysis

  10. Urea Alone is Not a Good Index of Dialysis Dose

    All-cause mortality in the HEMO study was not significantly related to removal of small solutes in short, intermittent, standard HD. “Failure to achieve greater reductions in solute levels may explain the failure of high Kt/V urea treatment to improve outcomes,” the authors note. (Yet another reanalysis of the HEMO study data has confirmed the obvious…)

    Read the abstract » | (added 04/12/2016)

    Tags: Hemodialysis