Children on dialysis have good survival prospects

Some of the longest survivors of ESRD were children or teens when their kidneys failed. A new study finds that 5-year survival of this group after they reach age 18 was 95.1%, with an average life expectancy of age 63 with a transplant—or age 38 with standard dialysis. Of course, two recent studies have found that survival with longer and/or more frequent HD rivals that of transplant.

Read the abstract » | (added 2011-02-24)

Tags:

Lower B2m levels predict better survival

More frequent—and especially longer—HD remove much more beta-2 microglobulin, a toxin that causes dialysis-related amyloidosis (DRA), with waxy protein deposits in bones, joints, and sometimes soft tissues. Since a new study has found that lower levels of B2m on dialysis predict survival, getting more dialysis is a plus!

Read the abstract » | (added 2011-02-24)

Tags:

Treatment length matters (we knew that!)

Even when the same number of blood liters are processed, long, slow dialysis does a better job of removing toxins. In a study where patients on HD were dialyzed for 4, 6, or 8 hours, the longer treatments removed significantly more urea, creatinine, phosphorus, and beta-2 microglobulin. The authors conclude that Kt/V should not be the only measure of dialysis adequacy.

Read the abstract » | (added 2011-02-24)

Tags:

Finally, data! Buttonhole Technique causes fewer fistula problems than site rotation

A new study compares 75 HD patients using the Buttonhole technique for fistula needles with 70 patients using the "standard" technique of "rope ladder" needle site rotation. Buttonhole users had fewer missed cannulations, bruises, and aneurysms, and needed less angioplasty. Infection precautions are vital: there was a higher infection rate.

Read the abstract » | (added 2011-02-24)

Tags:

Poor sleep on standard in-center HD

Good sleep on dialysis improves survival. A new study compared sleep quality on standard in-center HD and a control group matched for age, sex, body mass index, and race. The in-center HD patients had significantly worse sleep.

Read the abstract » | (added 2011-02-24)

Tags:

Consistent aspirin use associated with improved AVF survival among incident HD patients in the DOPPS

A new paper from the Dialysis Outcomes & Practice Patterns Study (DOPPS) reports that people who took aspirin had significantly less fistula failure than those who didn't. (Talk to your doctor about whether a baby aspirin or an adult aspirin might benefit you.)

Read the abstract » | (added 2011-02-24)

Tags:

Secondary arteriovenous fistulas: Converting prosthetic AV grafts to autogenous dialysis access

Dialysis fistulas tend to have fewer clots, infections, and hospital stays than grafts. Switching from a graft to a fistula was highly (90%+) successful after 2 years in a new study.

Read the abstract » | (added 2011-02-24)

Tags:

New study: Survival benefit for nocturnal HD

Researchers from the U.S. and Canada matched each of 94 people on nocturnal HD and 43 on short daily HD to 10 controls on standard HD. Even using the "proportional hazards model", they found a significantly lower risk of hospitalization and death on nocturnal, and a lower (but not significant) risk for daily, too.

Read the abstract » | (added 2011-02-24)

Tags:

Daily HD survival compares to transplant

A study by Kjellstrand et. al. pooling data from 1006 short daily HD patient years (415 patients, both at home and in-center) found 2–3 times better survival than on standard in-center HD. In fact, survival with daily HD was similar to that of deceased donor transplant. (Interesting that no-one disputes that survival is better with transplant than standard HD—though patients are selected for it (just as for home HD) and no randomized controlled trial has been done.)

Read the abstract » | (added 2011-02-24)

Tags:

Nocturnal HD survival matches that of deceased donor transplant

A new study used data from two Canadian programs and the USRDS (1994 to 2006) and randomly matched each of 177 people doing nocturnal HD to three people who'd had transplants. During up to 12 years of follow-up, 14.7% of the nocturnal dialyzors died, vs. 14.3% of those who'd had deceased donor transplants, and 8.5% of those who'd had living donor transplants.

Read the abstract » | (added 2011-02-24)

Tags: