Journal Watch
Survival in Those Eligible for BOTH PD or Standard In-center HD
Yes, this is yet another survival comparison. A study of almost a decade of people (N=2,032) starting dialysis at seven Ontario clinics looked at mortality only among those who were judged to be suitable for either PD or standard in-center HD by a multidisciplinary team. Both options offered similar survival.
Read the abstract » | (added 2017-12-14)
PD in PKD?
There is yet more evidence that people with PDK can successfully do PD. Researchers in Peking analyzed survival data from people with PKD between1993 and 2015 on PD vs. HD. Additionally, they matched PD patients who did and did not have PKD. Neither PD nor PKD independently predicted mortality.
Read the abstract » | (added 2017-09-15)
PD vs. Standard HD for People with Cirrhosis
For cirrhotic people with kidney failure, data abstraction from the U.S. Nationwide Inpatient Study between 2005 and 2012 compared outcomes with PD and standard in-center HD. In-hospital mortality for those with ascites was significantly less with PD. In addition, PD hospital stays were shorter and costs were lower. Yet, just 1.7% of the sample was using PD.
Read the abstract » | (added 2017-04-12)
Tags: Peritoneal dialysis, Hemodialysis
Results of a Metaanalysis of Nocturnal vs. Standard HD
Researchers who looked at 28 studies of 22,508 patients found a mixed bag: comparable side effects and mortality between nocturnal and standard HD, less hospitalization with standard HD—but better heart health and physical quality of life with nocturnal HD, with fewer blood pressure medicines needed.
Read the abstract » | (added 2017-03-09)
Tags: Hemodialysis
Time Matters: HD Kt Dose , Hospitalization, and Death
Does adding more HD benefit patients? Yes, finds a Fresenius study of 6,129 patients in Spain. There as a progressive increase in the risk of death for patients who were below the target Kt, and as Kt rose to reach and exceed the target, the risk declined, as did the risk of hospitalization. “Thus, prescribing an additional 3 L or more above the minimum Kt dose could potentially reduce mortality risk, and 9 L or more reduce hospitalization risk,” noted the authors.
Read the abstract » | (added 2016-11-10)
Tags: Hemodialysis
The HEMO Study Returns with a New Message
“An index only on the basis of urea does not provide a sufficient measure of dialysis adequacy,” finds yet another reanalysis of the by-now-ancient HEMO study data. Looking only at small uremic solutes—even non-urea wastes—did not predict all-cause mortality. Doing HD just three times a week made it impossible to remove enough solutes to matter.
Read the abstract » | (added 2016-11-10)
Tags: Hemodialysis
Overhydration and Mortality Risk on PD
When PD does not remove enough water, the resulting overhydration is a major risk factor for death. A study of 54 PD patients between 2008 and 2015 measured with bioimpedance technology were divided into normohydrated and overhydrated groups. Older age, low diastolic blood pressure and overhydration predicted mortality.
Read the abstract » | (added 2016-08-09)
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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
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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Why Do People Stop Doing Home HD?
Among 2,840 people who started home HD between 2007 and 2009, nearly one in four stopped within a year, while 1-year mortality was 7.6%. The risks of stopping home HD were higher among those with diabetes, and substance use (alcohol, tobacco, drugs). Those who were listed for transplant or lived in rural areas were less likely to stop home HD.
Read the abstract » | (added 2016-01-10)
Tags: Hemodialysis