Journal Watch
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For lupus, HD may be a better option
A small study of 36 women with lupus in Taiwan has found much better survival and less inflammation in those who did HD. Protein levels were higher on HD, too.
Read the abstract » | (added 2011-02-24)
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Better nutrition with nocturnal HD
A new study found better appetites, more energy, and higher protein intake in people doing 6 nights/week nocturnal HD. Even though they ate more foods high in phosphorus, their blood levels stayed good without binders. They were able to drink more fluids, too.
Read the abstract » | (added 2011-02-24)
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To reduce inflammation: Get rid of your HD catheter
Even with no infection, an HD catheter can still trigger inflammation. In a new study, people who got a fistula and had a catheter removed had an 82% lower c-reactive protein (CRP) level 6 months later. Those who kept the catheter had a 16% higher CRP.
Read the abstract » | (added 2011-02-24)
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Nocturnal HD normalizes smooth muscle cells
Blood vessel calcification is an all-too-common problem among people on dialysis. On standard HD, fewer smooth muscle cells grow inside the blood vessels, and more of them die. Switching from standard to nocturnal restored normal cell growth—and also lowered blood pressure, and PTH and phosphate levels.
Read the abstract » | (added 2011-02-24)
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The WAK is back...
The wearable artificial kidney (WAK) is still in development. In this most recent article, the developers have learned that a pulsing, rather than steady, flow of dialysate improves clearance of wastes. Activated charcoal is used to absorb Beta-2 microglobulin (which can cause dialysis-related amyloidosis). A dialyzer with a larger surface area and higher dialysate pH are also being tested.
Read the abstract » | (added 2011-02-24)
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Nocturnal HD improves melatonin rhythm for better sleep
Is sleep better or worse on nocturnal HD, since it is done at night? A new study of 13 people who switched from standard HD to nocturnal found that standard HD disrupts the normal rhythm of melatonin (the hormone that helps you sort out day from night). After 6 months of night-time treatments, this rhythm was partly restored—and sleep was much better.
Read the abstract » | (added 2011-02-24)
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Mind the gap
In the UK, "mind the gap" means watch your step as you get off the train. For in-center HD, the gap is the 2-day dialysis weekend. It turns out that switching randomly chosen patients from 3x/week to every other day HD for 12 months reduced blood pressure, left ventricular mass, EPO dose, urea rebound, and symptoms. Of course; it's more physiological!
Read the abstract » | (added 2011-02-24)
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CKD education saves lives
A new study from Taiwan found that people who got CKD education were about 3 times less likely to need dialysis during the study period (about a year), and more than 5 times more likely to live than a control group that did not receive the education.
Read the abstract » | (added 2011-02-24)
Tags: Chronic kidney disease
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Need an MRI? Ask for NAC + bicarb
MRI contrast dye can damage kidneys. A new meta-analysis (study of studies) has found that two approaches are better than one in preventing this damage. N-acetylcystein (NAC, or Mucomyst®) plus bicarbonate-based IV fluid reduced the risk of damage by 35%. The authors say this combo treatment should be used for all high-risk patients—including those with CKD.
Read the abstract » | (added 2011-02-24)
Tags: Chronic kidney disease
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PKD is not a barrier to successful PD
In a study that compared 56 people with polycystic kidney disease on PD to 56 non-diabetic people with small kidneys on PD, there were no differences between the two groups after 37 months.
Read the abstract » | (added 2011-02-24)
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