Higher HD Dose Linked with Better Survival

A national registry of 32,283 standard HD patients found that “a higher dose of dialysis was consistently associated with better survival.” Kt was most discriminating, with survival highest in the upper Kt quartile. Arteriovenous access, hemodiafiltration, scheduled dialysis initiation, and long weekly HD hours predicted higher Kt.

Read the abstract » | (added 2021-07-12)

Tags: Dialysis Frequency, Survival, Kt, Mortality

The Clinical Experience of In-center Nocturnal HD

An analysis of 4 years of INHD looked at 12 patients who chose to stop, 24 patients who continued, and interviews with patients and staff. A “starter pack” given to aid sleep in new INHD patients was well-received and sleep was not a reason to stop INHD. Staff were most concerned about emergency support, though staffing ratios were the same as during the day. Most of the clinical incidents for INHD centered around communication with patients and families, patient transfer delays, and equipment issues—not medical interventions, infection control, and transport, as during the day. Those who continued with INHD felt they had more social time and perceived health benefits.

Read the abstract » | (added 2021-07-12)

Tags: INHD

Is Endoscopy Safe in PD?

Peritonitis can occur after endoscopy. A retrospective 10-year review divided 570 PD patients who had 1,316 endoscopies into three groups. Group 1 did not have prophylactic antibiotics. Group 2 did have them. Group 3 had prior antibiotics. An analysis of the peritonitis rates within 7 days of the procedures found a 3% rate that was not affected by whether or not antibiotics were given.

Read the abstract » | (added 2021-07-12)

Tags: Endoscopy, Peritoneal Dialysis, Peritonitis

Roxadustat for Anemia in PD

The anemia drug was tested in 129 people on PD randomized to roxadustat or other ESAs for 24 weeks. The roxadustat group had a 96% response rate (vs. 92%), lower hepcidin levels and higher TIBC. Total cholesterol and LDL dropped more with roxadustat, independently of C-reactive protein. Mean average hemoglobin on roxadustat were 11.5 g/dL (vs. 11.2). There were some common adverse events.

Read the abstract » | (added 2021-07-12)

Tags: Prolyl Hydroxylase Inhibitor, Erythropoiesis, Iron Metabolism, Anemia

Genes Help Predict Peritoneal Transport Rates

Among 2,850 people on PD who had complete genetic data, 5 single nucleotide variants at four loci had suggestive associations with the peritoneal solute transfer rate (PSTR), in particular rs28644184 at the KDM2B locus.

Read the abstract » | (added 2021-07-12)

Tags: Genetic Variants, Peritoneal Solute Transfer Rates, Kidney Failure, Peritoneal Dialysis

PD Adequacy and Itching

Among 80 people on CAPD, blood levels of the pain marker “substance P” and total urea clearance both independently predicted itching. Inadequate PD seems to be a reason for people using PD to itch.

Read the abstract » | (added 2021-07-12)

Tags: Pruritus , Peritoneal Dialysis, CAPD, Substance P, Total Urea Clearance, Itching, PD

Safety Study of the PD Automated Wearable Artificial Kidney

In the AWAK pilot study, 15 participants used up to nine sessions over 72 hours and were then followed for one month. There were no serious adverse events, but 60% of participants had abdominal pain and 47% reported bloating. Median body weights were not significantly different before and after the study. Device enhancements will address ultrafiltration and pain.

Read the abstract » | (added 2021-06-15)

Tags: Wearable Kidney, Artificial Kidney, Chronic Kidney Disease, Peritoneal Dialysis

PD vs. Standard In-Center HD for Stroke Risk: A 14-year Study

Of 7,916 ESRD patients with atrial fibrillation between 2001 and 2013, data from 363 PD and 5,302 HD patients were analyzed. At 1 year, 3 years, and 5 years, the participants who used PD had significantly lower risks for outcomes including stroke, major bleeding, and intracranial hemorrhage than those using HD.

Read the abstract » | (added 2021-06-15)

Tags: ESRD, End Stage Renal Disease, Atrial Fibrillation, Peritoneal Dialysis, Hemodialysis, Patient Outcomes

Home vs. In-center HD Outcomes from a Matched Cohort

After adjusting for BMI, smoking, race, and comorbidities, home HD came out ahead of in-center HD when 181 home HD patients were matched to 413 using in-center HD. With home HD, the risk of death was significantly less, and phosphate levels were significantly lower. There were no major differences in transplant rates, graft survival, hemoglobin, calcium, or PTH levels.

Read the abstract » | (added 2021-06-15)

Tags: Dialysis Modality; End stage Kidney Disease; Haemodialysis, Hemodialysis, Home Haemodialysis, Home Hemodialysis, Mortality

In-center Nocturnal HD Improves Quality of Life vs. Standard In-center HD

A small prospective cohort study of standard in-center HD patients (n=36) who switched to in-center nocturnal HD compared baseline health-related quality of life to levels 12 months later. Among the 24 who completed the study and permitted follow up, the mental component score increased by 7.1 points, and improvements were seen in several domains.

Read the abstract » | (added 2021-06-15)

Tags: In center Nocturnal Hemodialysis, Health related Quality Of Life, End stage Renal Disease, KDQOL 36