Journal Watch
87 people on nocturnal home HD for 12 years had just 30% the mortality of standard HD
How does survival of people on nightly home HD compare to those in the USRDS? A single-center study of 87 people who got 40±6 hours a week of HD found that 79% lived 5 years, and 64% lived for 10 years—a mortality rate just 30% of the USRDS average. Higher levels of education and more hours of dialysis were the only factors independently linked with survival.
Read the abstract » | (added 2011-04-25)
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Oral adsorbents may help reduce levels of uremic toxins
The colon makes some wastes that are removed by the kidneys. So, drugs that keep these wastes from getting into the bloodstream could help keep them from building up in the body when the kidneys fail.
Read the abstract » | (added 2011-04-25)
Tags: Chronic kidney disease
Better PD technique survival in people with diabetes who use icodextrin
In the first randomized control trial using icodextrin in lieu of glucose for PD solution, 41 people with diabetic nephropathy were assigned one or the other. After 2 years, 71.4% of the icodextrin group was still doing PD, while only 45% who used glucose-based solution still did PD.
Read the abstract » | (added 2011-04-25)
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Fleet enemas can safely be added to nocturnal HD dialysate to boost phosporus levels
Nocturnal HD removes so much phosphorus that dialyzers may need supplements. Fleet® enemas are a low-cost, easy-to-obtain source of phosphorus. The amount of added phosphorus was predictable, and the product did not add bacteria or endotoxin to the dialysate.
Read the abstract » | (added 2011-04-25)
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More working-age dialyzors who chose PD kept their jobs, found a study of 102,104 people
Each year, half of all new dialyzors are working-age (<65), but most stop work after starting treatment. An analysis of USRDS data from 1992–2003 of people who were working 6 months before dialysis found that those most likely to work were: 1) white men ages 30–49; 2) those with glomerular, cystic, or urologic causes of ESRD; 3) those who chose PD first; 4) those with employer group health plans; 5) those who received ESAs.
Read the abstract » | (added 2011-04-25)
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Nocturnal HD makes pill regimens simpler but doesn't require less pill use
A study of 35 people on nocturnal home HD looked at how complex their pill regimens were, and how many pills they needed each day. After 2 years, they still needed just as many pills—but the regimen was much simpler. Dialyzors needed fewer BP pills and binders, but more vitamins and antibiotics.
Read the abstract » | (added 2011-04-25)
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CAPD maintains residual kidney function better than APD
A new study followed 505 people on CAPD and 78 on APD for 3 years. The two groups had no major differences in residual kidney function (RKF) at baseline, but those on APD had a much higher risk of RKF loss in the first year. The highest risk of losing all RKF was found in those who had the highest GFRs at the study start.
Read the abstract » | (added 2011-04-25)
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Chemical ablation to correct recurrent secondary hyperparathyroidism post parathyroidectomy
Reoperation after a parathyroidectmy can be risky. In a study of 49 people, injecting ethanol (alcohol) into the gland, guided by ultrasound, helped to lower PTH levels without more surgery.
Read the abstract » | (added 2011-04-25)
Tags: Chronic kidney disease
Switching from 3x4 hours HD to 6x3 hours reduced blood pressure, and improved hgb, albumin, & BMI
Healthy kidneys work 168 hours a week, but most people only get about 12 hours of dialysis. In this study, 11 people were switched to more frequent HD. After 12 months, they had significantly better blood pressure with fewer meds, higher hgb levels with lower ESA doses, higher albumin levels, lower dry weight, and better BMIs. Calcium-phosphorus products dropped significantly with no changes in binder doses.
Read the abstract » | (added 2011-04-25)
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Long, slow HD removes more small & middle molecules than standard HD
A study that processed the same total blood and dialysate volume on two different time schedules looked at the importance of treatment time. Eleven people had a 4-hour and an 8-hour HD session, at least one week apart. Significantly more small and middle molecules were removed in the 8-hour treatments, though protein-bound solutes were not affected.
Read the abstract » | (added 2011-04-25)
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