Journal Watch - Home dialysis

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  • Dealing with Home HD Technology: Patients and Families

    An interview study was conducted with 19 home HD patients and carers who successfully used one of five different home HD machines. Respondents believed the machines were safe—but were still scared at first, and learned through mistakes. Machines that guide patients and carers (such as with step by step instructions) and help families communicate better with professionals (such as with remote monitoring) may be helpful.

    Read the abstract » | (added 2015-01-08)

    Tags: Home dialysis

  • How to prescribe intensive home HD: A guide for the nephrologist

    This article describes each of the types of intensive home HD, and offers prescription guidance from experts.

    Read the abstract » | (added 2014-12-09)

    Tags: Home dialysis

  • Cochrane database review favors home HD over standard in-center HD

    Just one, small (n=9) randomized controlled trial (RCT) lasting 8 weeks could be found that looked at home HD (extended) vs. standard in-center HD in adults. But, based on this, the Cochrane Database Systematic Review was able to get a paper published. Home HD reduced 24 hour blood pressure and improved uremic symptoms. The authors recommend more RCTs.

    Read the abstract » | (added 2014-12-09)

    Tags: Home dialysis

  • Home therapies: Better outcomes

    A review article suggests that outcomes for PD and home HD are as good—or better—than those for standard in-center HD. PD use in the US has grown after the Medicare bundle created an incentive for its use. Home therapies are effective and patient-centered treatments.

    Read the abstract » | (added 2014-10-07)

    Tags: Home dialysis

  • Nocturnal home HD boosts hemoglobin level and reduces ESA use

    Every other night nocturnal home HD (NHHD) was compared to standard in-center HD in a small study. Among the 23 people using NHHD, Hemoglobin increased by about 2 g/dL after 2 years (P<0.001), while ESA dose dropped by just over 50% (P<0.001), and 26% were able to stop ESAs. Among the 25 people doing standard HD, hemoglobin levels dropped by almost 2 g/dL (P = 0.007), and ESA dosage increased (P<0.001).

    Read the abstract » | (added 2014-10-07)

    Tags: Home dialysis, Nocturnal Hemodialysis

  • VOLUME FIRST to improve outcomes in people on HD

    We try to include only HOME dialysis abstracts—but when the Chief Medical Officers of most of the US dialysis clinics agree on key messages to improve care, we need to summarize their four key points. These are: (1) Normalizing extracellular fluid volume should be a primary goal of dialysis. (2) Fluid removal should be gradual and treatments should not routinely be less than 4 hours. (3) Keep dialysate sodium in the range of 134-138 mEq/L and avoid routine sodium modeling and hypertonic saline. (4) Counsel consumers to avoid salt in their diets.

    Read the abstract » | (added 2014-09-05)

    Tags: Home dialysis