Journal Watch
Magnesium and Vascular Calcification in PD
In vitro and in animals, serum magnesium inhibits vascular calcification. In a study of 80 people on PD, X-ray studies of the spine found that the lower the serum magnesium levels, the higher the rate of calcification in the blood vessels. Adjusting for age, serum phosphate, serum PTH, cholesterol levels, smoking history, and diabetes did not change the results.
Read the abstract » | (added 2017-04-12)
In-center Nocturnal HD Beats Standard HD
An analysis of 21 published studies (n=1,165 in-center nocturnal patients and 15,865 standard in-center HD patients) found better BP, higher Hgb, and lower serum phosphate levels in those who dialyzed longer.
Read the abstract » | (added 2017-04-12)
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
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
WAK Clearance of Potassium and Phosphorus in Goats
Wearable dialysis could ease fluctuations in potassium and phosphorus vs. intermittent HD. A sorbent based wearable device tested on goats found constant levels of potassium and phosphate adsorption.
Read the abstract » | (added 2016-06-08)
Survival on PD is Better with Normal Magnesium Levels
A retrospective study of 253 incident PD patients followed for up to 10 years found that deaths due to cardiovascular causes (58.3%) were linked with low serum magnesium levels. Low serum albumin, and levels of triglycerides, potassium, calcium, and phosphate were also important. Those in the group with the lowest magnesium had significantly higher all-cause mortality (p<0.001).
Read the abstract » | (added 2016-04-12)
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Short daily HD may reduce phosphate burden vs. standard HD
In a small study of short daily HD users (n=24) vs. standard in-center HD users (n=54), serum calcium, serum phosphorus, and PTH levels were similar between the two groups. But, levels of fibroblast growth factor 23—which may be a marker of cumulative phosphate burden in the body—were significantly lower with short daily HD (P<0.01).
Read the abstract » | (added 2014-03-07)
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Nocturnal in-center HD comes to Slovenia
Only a few handfuls of US clinics offer nocturnal in-center HD. Now, Slovenian researchers report their experience of switching 10 patients from "standard" (4-5 hours!) in-center treatments to thrice weekly 8-hour long nighttime ones. With almost twice as much dialysis per week, mean predialysis creatinine and urea dropped significantly, as did mean dry weight. Six of the ten were able to stop taking phosphate binders, and one more patient had a dose reduction—and phosphate was added to the dialysate for three patients. There were no major changes in predialysis blood pressure, calcium or potassium levels, mean ultrafiltration, hemoglobin, or EPO dose (Editor's note: perhaps because standard HD in Slovenia is longer, and because the nocturnal treatments were only three times per week).
Read the abstract » | (added 2013-10-02)
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Mineral balance in long HD
A metaanalysis from Canada of 21 studies concluded that keeping dialysate calcium ≥1.5 mmol/L for most patients on long/long-frequent HD prevents an increase in PTH levels and a decline in bone mineral density—without raising the risk of calcification. Adding phosphate to the dialysate for those with a low predialysis level or very low level makes sense.
Read the abstract » | (added 2013-08-22)
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Phosphate is a blood vessel toxin
If blood phosphate levels are too high, the blood vessels can turn to stone—even in children. Heart damage from high phosphate levels can begin in pre-dialysis CKD. "Keeping serum P levels in the normal range reduces cardiovascular risk and mortality," say the authors. [Editor's note: nocturnal hemodialysis removes the most phosphate of any dialysis option.]
Read the abstract » | (added 2013-05-24)
Tags: Chronic kidney disease