Fewer hospital days with home HD

Is home HD really better—or does it just look better because younger, healthier people choose to do it? Researchers looked at hospital days of 25 people on home HD vs. 25 standard in-center HD patients who were healthy enough to be on the transplant list. Across the group, home HD patients spent 71 days in the hospital, and standard in-center HD patients spent 85 (P<0.005). The authors concluded that this study “confirms the superiority of the HHD treatment option in improving patient outcomes.

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

Tags:

Home HD: Flexibility, control, and independence

In-depth interviews with 24 home HD patients in New Zealand found that dialysis was disruptive in terms of the body and the time it takes—but also a positive experience on many levels, especially the way people relate to others.

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

Tags:

First-year outcomes of incident US PD patients

Among 1,677 incident PD patients from Fresenius, 367 switched to HD within the first 90 days. Of those who continued with PD, first-year mortality was 10 per 100 patient-years, with 42 episodes of peritonitis and 128 hospitalizations per 100 patient-years. About 2/3 of the hospitalizations occurred in the first 6 months of PD therapy. Of those who switched to HD, 81.4% began treatment with a central venous catheter—and 78.3% still had one 90 days later.

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

Tags:

X-rays predict functional PD catheter problems in advance

The PD catheter angle (inclination) as seen on X-ray was able to predict functional problems during 36 months of follow up, in a new study of 110 consecutive patients getting a first PD catheter. Only inclined catheters had to be surgically corrected.

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

Tags:

All about icodextrin – in one place

A new review explains why and how to use icodextrin appropriately and avoid adverse events. Learn about the hemodynamic, metabolic, and idiopathic effects of this glucose-sparing PD fluid so you can prescribe it with confidence.

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

Tags:

Following the PD treatment plan – a stepwise approach

How do people learn to follow a treatment plan? Not all at once, finds a new nursing interview study of 36 PD patients (half male, half female) from Hong Kong. The researchers found three stages of PD adherence. First, new patients tried to follow instructions, but could not do so strictly and persistently. After 2-6 months, they adhered selectively by experimenting, checking their progress, and adjusting. Finally, after 3-5 years, they fit their regimens into their day-to day-lives.

Read the abstract » | (added 2014-06-05)

Tags:

Transplant still beats home HD in Canada

A retrospective study looked at 173 patients using intensive HD (>16 hours/week) and a total of 1,517 who received a kidney transplant. Those on dialysis had fewer hospital stays in the first 3 months to a year. But, those with transplants had fewer treatment failures or deaths.

Read the abstract » | (added 2014-06-05)

Tags:

Home HD survival in New Zealand

Researchers analyzed 15 years worth of home HD data in NZ (6,419 patients and 20,042 patient-years of follow up). After adjusting for comorbidities, home HD had 52% better survival than in-center HD. PD had 20% better survival than in-center HD in the first 3 years—but a 33% higher mortality risk after that.

Read the abstract » | (added 2014-06-05)

Tags:

Can short daily HD treat hypertension on dialysis?

Ah, cherish the rare RCT in dialysis. In this study, a group of standard HD patients with high blood pressure were switched to short daily HD to see if it could reduce their BP (and if so, how). Bioimpedance was used to check extracellular fluid volume (ECFV). Inflammation and oxidative stress were also measured. After 3 months, BPs were similar between the two groups—but the short daily HD patients needed significantly fewer BP medications. The reason for the difference is still a mystery.

Read the abstract » | (added 2014-06-05)

Tags:

Web e-learning boosts home dialysis knowledge in Australia

A 3-module e-learning package was developed for a “Home First” project in Australia and tested on 88 undergraduate health professionals. The students knew little about home dialysis before using the modules, and improved significantly afterward.

Read the abstract » | (added 2014-06-05)

Tags: