The Q-Cohort Study: More Dialysis, Less Risk of Cancer

Uremic toxins increase cancer risk. In a study of 3,450 HD patients followed for 4 years, patients were divided into quartiles based on their baseline Kt/V. Four-year survival dropped linearly along with Kt/V. Every 0.1 increase in Kt/V reduced the risk of cancer death by 8%.

Read the abstract » | (added 2020-02-19)

Tags: Dialysis Dose, Cancer Death, Hemodialysis, Uremic Toxins, Kt/V

Green Nephrology: Reducing the Environmental Impact of Dialysis

Climate change and extreme weather events both increase the incidence of kidney disease and destabilize care. But, healthcare in general—and dialysis in particular—contribute substantially to greenhouse gases. Monitoring resources and reducing waste in HD can be done through reuse of RO reject water, renewable energy sources, better waste management, and slower dialysate flow rates. For PD, point-of-care dialysate will reduce the environmental impact.

Read the abstract » | (added 2020-02-19)

Tags: Environmental Change, Kidney Disease Factors, Environmental Impact Of Dialysis

Survival with PD vs. Home HD and When to Go Home

Using a national cohort of 1,993 patients transitioning to home HD and 16,514 to PD between 2007 to 2011, 1,195 home HD were matched to 1,195 using propensity scores and adjusting for demographics, comorbidities, dialysis duration, and BMI. Those on home HD had significantly better survival (9.6 vs. 12.9 deaths per 100 patient-years; p<0.001). However, when patients switched to PD within the first 12 months of starting dialysis, survival was comparable between PD and home HD: patients who transitioned after 12 months had an 83% higher risk of death.

Read the abstract » | (added 2020-02-19)

Tags: Home HD, PD, Comorbidities, Dialysis Duration, BMI, Survival

Exercise in PD Patients and Residual Renal Function

After a 12-week home-based exercise program was completed, researchers analyzed residual renal function among 13 patients who received usual care and 16 who had been in the exercise intervention group. Urinary liver-type fatty acid-binding protein and microalbumin-to-creatinine ratios were significantly lower in the exercise group, suggesting a possible benefit.

Read the abstract » | (added 2020-02-19)

Tags: Exercise, Renal Outcome, Residual Renal Function, Peritoneal Dialysis

PD Glucose Absorption and Lipid Profiles

Lipid status was assessed at baseline and 12 month in 143 CAPD patients, 2/3 of whom used a daytime icodextrin exchange. No associations were found between glucose absorption, lipid profiles, or changes in serum lipids.

Read the abstract » | (added 2020-02-19)

Tags: Peritoneal Dialysis, Cholesterol, Glucose, Triglycerides

Comorbidities—but not Peritonitis—drove Mortality on PD

Among 242 Turkish PD patients followed for up to 9 years, age over 65, diabetes, cancer, and heart failure were independent risk factors for death, but surprisingly peritonitis was not.

Read the abstract » | (added 2020-02-19)

Tags: Peritoneal Dialysis, Mortality, Patient Survival, Peritonitis, Technique Survival

First European Patients Using Nocturnal Home HD with Low-flow Dialysate

A retrospective analysis looked at 21 patients using low-flow dialysate for nocturnal home HD and followed for a minimum of 12 months. Participants had a mean dialysis duration of 28 hours per week; most used alternate nights and 50-60 L of dialysate per session. Use of phosphate binders and blood pressure medications was significantly reduced, and no patient safety events were reported.

Read the abstract » | (added 2020-01-09)

Tags: Low flow Dialysate, Nocturnal Home HD, Phosphate Binders, Blood Pressure Medication

Home HD: Hospitalizations and Technique Survival

In a Swedish registry study, patients initiating PD (n=456), home HD (n=152), and in-center HD (IHD; n=608) were matched by age, sex, comorbidity, and start date. Patients using home HD had significantly lower hospital admissions and days than those doing PD or IHD (1.7, 12 days vs. 2.8, 20 days and 2.2, 14 days respectively). Home HD patients also had significantly fewer admissions for cardiovascular diagnoses or infectious disease, as well as significantly longer technique survival.

Read the abstract » | (added 2020-01-09)

Tags: PD, Home HD, In center HD, Hospital Admissions, Cardiovascular Diagnosis, Infectious Disease, Technique Survival

Factors Associated with Fatigue in PD Patients

Analysis of fatigue scale data from 108 PD patients in China revealed that 78.7% suffered from fatigue, a number significantly higher than in the community population. Associated factors included sleep quality, normalized protein nitrogen appearance, transferrin, alkaline phosphatase, and total cholesterol levels.

Read the abstract » | (added 2020-01-09)

Tags: Fatigue, PD, Sleep Quality, Protein Nitrogen Appearance, Transferrin, Alkaline Phosphatase, Total Cholesterol Levels

Low-dose IV Iron Sucrose for Treatment of Anemia in PD

A small study (n=18) of IV iron sucrose (200mg loading dose followed by 100mg monthly for 5 consecutive months) found reductions in ESA dosing for 5 patients and discontinuation in one, with no reported side effects.

Read the abstract » | (added 2020-01-09)

Tags: IV Iron Sucrose, Anemia, ESA Dosing