Journal Watch
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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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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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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
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PD (vs. in-center HD) and less bad breath
After 3 months on PD, 42 people in a new study had more saliva—and less bad breath.
Read the abstract » | (added 2011-03-30)
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AAKP's study of patient satisfaction with kidney education and dialysis (hint: not so good)
977 patients completed a 46-item survey asking about satisfaction with current treatment for kidney failure and education on a scale of 1–10 (with 1 low). Standard in-center HD rated 4.5. PD rated 5.2, home HD was 5.5, and transplant was 6.1. About 31% of participants felt the treatment options were not equally and fairly presented, and 32% had not been educated about home HD.
Read the abstract » | (added 2011-03-30)
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Benefits of switching from 3x/week in-center HD to 6x/week home HD
Among 11 people who switched treatments, blood pressure dropped, hemoglobin levels rose (with lower ESA doses), the calcium-phosphorus product dropped (with no change in binder doses), and BMI and serum albumin levels went up. We are so not surprised!
Read the abstract » | (added 2011-03-30)
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Simpler pill regimen needed by those using nocturnal home HD
Among 35 people who switched from standard in-center HD to nocturnal home HD, the number of pills per day did not drop—but the regimen was much simplified—and health-related quality of life was significantly improved.
Read the abstract » | (added 2011-03-30)
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Better fluid removal with icodextrin PD fluid - Meta-analysis
A new study of 9 randomized controlled trials has found that people using icodextrin removed much more water than those using glucose based fluid—with no change in residual kidney function or increase in peritonitis or death. Rash was more common in those using icodextrin.
Read the abstract » | (added 2011-03-30)
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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)
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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)
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