Frequent HD in Children

Does 5x/week in-center HD benefit children more than 3x/week treatments? A multicenter pilot followed 8 children with a median age of 16.7 years. Among the 6 patients who completed two study periods, 5 had a sustained 10% or more decrease in systolic BP or antihypertensives during the more frequent treatments. Reimbursement and time burdens are challenges.

Read the abstract » | (added 2017-04-12)

Tags: Hemodialysis

Striking Lack of Data on Infection Prevention in PD

A Cochrane database review of 59 randomized controlled studies revealed “striking” gaps in our knowledge about what really works to prevent infections in PD. Oral or topical antibiotics and topical disinfectants had uncertain benefits for exit site, tunnel infections, or peritonitis. Use of IV vancomycin prior to catheter placement may reduce the risk of early peritonitis. Antifungal treatments may reduce fungal peritonitis after antibiotics.

Read the abstract » | (added 2017-04-12)

Tags: Peritoneal dialysis

In-center Nocturnal HD Beats Standard HD

An analysis of 21 published studies (n=1,165 in-center nocturnal patients and 15,865 standard in-center HD patients) found better BP, higher Hgb, and lower serum phosphate levels in those who dialyzed longer.

Read the abstract » | (added 2017-04-12)

Tags: Hemodialysis

Pregnancy on PD—at 42: It’s Not Impossible

While research shows that the chance for a pregnant woman on dialysis to have a healthy baby seems to be best with 36+ hours of HD per week, a 42-year old Malaysian woman had a full-term baby with no change to her CAPD prescription.

Read the abstract » | (added 2017-04-12)

Tags: Peritoneal dialysis, Hemodialysis

PD and Serum Vitamin D—A Vital Link

People with no history of heart disease on PD for 3+ months were compared to age- and sex-matched healthy controls in a 24-month study of subclinical atherosclerosis. Those on PD had significantly more carotid and femoral plaques at baseline than controls. Lower levels of serum vitamin D predicted more plaque at baseline and at 24 months. The authors suggest that monitoring could help identify patients who are at higher risk.

Read the abstract » | (added 2017-03-09)

Tags: Peritoneal dialysis

Home HD: Cost-effective With Better Outcomes Than In-center

A review of the patient-centered and economic impacts of home HD that included studies between 2000 and 2016 found better quality of life, flexibility, employment potential, and survival vs. hospital HD. Minority and low-income patients still have less access than others, which compounds their already-poor health outcomes. The authors found that home HD is cost-effective and the use of this option should be increased.

Read the abstract » | (added 2017-03-09)

Tags: Hemodialysis

And, Again: More HD Improves Quality of Life

Data from the Frequent Hemodialysis Network (FHN) trials found that those who were randomized to frequent or nocturnal HD reported outcomes that included better results on a “feeling thermometer,” better general health, and shorter recovery time than for standard in-center HD.

Read the abstract » | (added 2017-03-09)

Tags: Hemodialysis

Results of a Metaanalysis of Nocturnal vs. Standard HD

Researchers who looked at 28 studies of 22,508 patients found a mixed bag: comparable side effects and mortality between nocturnal and standard HD, less hospitalization with standard HD—but better heart health and physical quality of life with nocturnal HD, with fewer blood pressure medicines needed.

Read the abstract » | (added 2017-03-09)

Tags: Hemodialysis

The Impact of Telehealth on PD Satisfaction

Per quarterly surveys completed by 200 people on PD, a system of telemedicine that included remote monitoring of blood pressure, weight, and glucose, and had educational videos boosted satisfaction with the option. Participants felt more autonomy and confidence in their health care, as well, and were less frustrated. Nearly half watched at least one video.

Read the abstract » | (added 2017-03-09)

Tags: Peritoneal dialysis

Does Frequent HD Boost Quality of Life? NO

A new Canadian study randomized 200 patients to standard in-center HD (12-15 hours/wk; maximum of 18 hours) or extended HD (>24 hours/wk) for a year. Extended HD reduced phosphate and potassium levels and boosted Hgb, and patients took fewer BP meds and phosphate binders. However, health-related quality of life scores did not differ significantly between the groups.

Read the abstract » | (added 2017-02-08)

Tags: Hemodialysis