PD vs. Standard HD for People with Cirrhosis

For cirrhotic people with kidney failure, data abstraction from the U.S. Nationwide Inpatient Study between 2005 and 2012 compared outcomes with PD and standard in-center HD. In-hospital mortality for those with ascites was significantly less with PD. In addition, PD hospital stays were shorter and costs were lower. Yet, just 1.7% of the sample was using PD.

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

Tags: Peritoneal dialysis, Hemodialysis

Ultrafiltration: Speed Kills

Among 190 people on HD, those whose ultrafiltration (fluid removal) rate was higher than the median (just 6.8 mL/Kg/h) were less likely to survive than those who were at or below the median. Most participants did not have residual kidney function.

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

Tags: 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

Does Frequent HD Boost Quality of Life? YES

As with nearly every other study, a new paper from the Frequent Hemodialysis Network trial looked at HRQOL among patients randomized to conventional vs. 6x/week HD (N=245) or 6x/week nocturnal vs. conventional home HD (N=87). After one year, patients who dialyzed more often had higher HRQOL than those on standard HD—and shorter recovery after each treatment.

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

Tags: Hemodialysis

A New Approach for Treating Peritonitis in Patients Over Age 50

Researchers tried a new, 3-step “Mero-PerRest” protocol when patients over age 50 developed peritonitis due to enteric (gut) microorganisms. 1). Temporary “peritoneal rest” with the catheter in place. 2). IV meropenem. 3). Meropenum as a catheter lock. Compared to 203 bouts of peritonitis treated with usual care, 217 bouts treated with the new protocol had a higher primary cure rate (90% vs. 65.3%), better PD survival (90% vs. 64.9%), and similar patient survival.

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

Tags: Peritoneal dialysis