Informed decision-making about dialysis options

Among 99 dialysis patients from 15 clinics in North Carolina, 67% said they felt like they had no choice about their modality, and about a third felt that the choice had already been made by their doctor.

Read the abstract » | (added 2013-08-22)

Tags: Chronic kidney disease

Predialysis patient education boosts use of PD

In a 4-year period, 227 patients attended a CKD education program. Compared to a control group who did not attend, the educated patients were almost twice as likely to choose PD (54.3% vs. 28%).

Read the abstract » | (added 2013-08-22)

Tags: Chronic kidney disease

Wearable and implantable artificial kidneys

Thrice weekly in-center HD for 4 hours or less is a paradigm that must change to improve patient outcomes. But longer and/or more frequent treatments are not practically available to the total dialysis population. Thus, radical new approaches are needed—like wearable devices or implantable ones.

Read the abstract » | (added 2013-08-22)

Tags: Chronic kidney disease

New Vwing device helps start Buttonholes

A new, surgically implanted device used for 387 cannulations over 6 months in 9 patients was successful 94% of the time. But, standard cannulation for the other needle only worked 77% of the time. This device may help with difficult to cannulate fistulas.

Read the abstract » | (added 2013-08-22)

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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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PD Dialysate With Hydrogen May Protect Peritoneal Membranes

Over time, the peritoneum can be harmed by glucose degradation products in PD dialysate. In 6 patients, PD fluid with dissolved hydrogen significantly reduced oxidative stress vs. standard PD fluid.

Read the abstract » | (added 2013-07-17)

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Better Blood Sugar Control, Fewer PD Infections

No surprises here: blood sugar control matters in PD. A study that looked back at 183 PD patients found that those with poor control were more than twice as likely to have had an exit site or catheter infection as those with good control.

Read the abstract » | (added 2013-07-17)

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Itching? It May Be Due To High Calcium—Not Phosphorus

A study of 120 HD patients found high levels of serum phosphorus and parathyroid hormone (PTH) in those with and without dialysis itching (pruritus). But, the itchiest patients had significantly higher serum calcium levels.

Read the abstract » | (added 2013-07-17)

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Impact of frequent HD on residual kidney function

We know that PD can help residual kidney function last longer. What happens with longer and/or more frequent HD? Results from the FHN trials suggest that residual kidney function loss may be faster with these options. [Editor's note: But, if more kidney replacement therapy is given, does it matter?]

Read the abstract » | (added 2013-05-24)

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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