Journal Watch

  1. 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 05/24/2013)

    Tags: Hemodialysis

  2. 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 05/24/2013)

    Tags: Chronic Kidney Disease

  3. More HD lowers C-reactive protein and boosts nutritional status

    A study from Iran found that adding one standard HD treatment per week for 6 weeks significantly decreased C-reactive protein (a measure of inflammation), and increased serum albumin and BMI. The authors conclude that getting more HD may reduce the risk of cardiovascular events.

    Read the abstract » | (added 04/29/2013)

    Tags: Hemodialysis

  4. Swedish patients who do home HD first have excellent survival

    In Sweden, 128 patients who chose home HD as their first treatment and were under age 60 had 10-year survival of 75%, 20-year survival of 47%, and 30-year survival of 23%. For patients in this age group, getting a transplant did not further improve survival.

    Read the abstract » | (added 04/29/2013)

    Tags: Hemodialysis

  5. Nocturnal home HD – no change in outcomes if a partner is needed

    Do Canadian nocturnal home HD patients do worse if they need a partner to help them? No, says a study of 152 people, 47 who needed partners and 105 who could do their treatments unaided. Partner dependent patients were older, more likely to have diabetes, and had more comorbidities. But, there were no significant differences between groups in time to first hospitalization, technique failure, or survival.

    Read the abstract » | (added 04/29/2013)

    Tags: Hemodialysis

  6. Patients with diabetes & renters may need extra help for home HD

    Among 177 Canadian patients who started home HD training, 24 did not finish and 8 had technique failure in the first year. The strongest predictors of failure were diabetes or rented housing. These patients may need extra support to succeed.

    Read the abstract » | (added 04/29/2013)

    Tags: Hemodialysis

  7. Daily HD does not harm accesses – a prospective, controlled study

    A 4-year study was done of 51 on standard HD (3x4 hours) vs 23 on daily HD (6x3 hours). The standard HD group had 543.2 access procedures/1000 patient years; the daily group had 400.8. Adjusting for age, gender, diabetes, phosphorus level, and anemia, there were no significant differences in number of procedures or time to first access revision.

    Read the abstract » | (added 04/29/2013)

    Tags: Hemodialysis

  8. New hope for stopping peritoneal fibrosis

    There are vitamin D receptors all over the body. Low levels of vitamin D have been linked with severe fibrosis. This study gave mice peritoneal fibrosis and then looked at the impact of treatment with a vitamin D analog (22-oxacalcitriol). The treatment significantly prevented fibrosis and thickening of the peritoneum.

    Read the abstract » | (added 04/29/2013)

    Tags: Peritoneal Dialysis

  9. Starting more people on PD does not cause harm

    In Canada, a study looked at PD "attempt rates": how often each nephrologist would start new patients on PD. Between the highest and lowest attempt rates, there were no differences in PD success—or survival. The authors conclude that maximizing PD start rates can save money to help more people, with no harm to patients.

    Read the abstract » | (added 04/29/2013)

    Tags: Peritoneal Dialysis

  10. Icodextrin metaanalysis – no impact on patient survival

    Australian researchers analyzed 11 studies of icodextrin vs. glucose PD fluid (1222 patients). Icodextrin did help reduce fluid overload without harming residual kidney function. But, it did not help reduce peritonitis, technique failure, or other adverse events. And, patients who used icodextrin did not live any longer.

    Read the abstract » | (added 04/29/2013)

    Tags: Peritoneal Dialysis