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 2016-07-12)

Tags: Hemodialysis

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 2016-06-08)

Tags: Hemodialysis

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 2016-06-08)

Tags: Hemodialysis

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 2016-06-08)

Tags: Hemodialysis

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 2016-06-08)

Tags: Hemodialysis

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 2016-05-12)

Tags: Hemodialysis

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 2016-05-12)

Tags: Hemodialysis

Survival on PD vs. Daily Home HD

A USRDS study matched 3,142 people starting daily home HD with 2,688 starting PD and compared survival. Those who were doing short daily HD had 12.7 deaths per 100 patient years, vs. 16.7 in the PD group.

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

Tags: Hemodialysis

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 2016-04-12)

Tags: Hemodialysis

Sleep Problems With Automated PD

Compared to people with stage 3b-5 CKD (n=89), those using a cycler for PD (n=22) had about the same, higher level of sleep problems as those on standard HD (n=75). In-home sleep measures and surveys found low levels of oxygen during sleep, and disrupted sleep cycles.

Read the abstract » | (added 2016-03-10)

Tags: Hemodialysis