PD vs. In-center HD for Time to Transplant (in Italy)

In the US, research has found that people who use PD receive transplants about 50% faster than those on standard in-center HD, despite comparable listing numbers. The same seems to be true in Italy. In the Province of Trento, which has increased PD use from 7 to 47%, an analysis of 279 HD and 132 PD patients found that time to transplant was about 330 days for HD and 224 for PD—a significant difference.

Read the abstract » | (added 2016-12-09)

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NxStage Outcomes in France and Belgium

Among 62 patients from 31 centers in France and Belgium, albumin and bicarbonate levels improved significantly, and technique survival was 75% at one year (most who stopped received transplants). Despite the low volume of dialysate, the rsearchers concluded that dialysis adequacy was acceptable.

Read the abstract » | (added 2016-12-09)

Tags: Hemodialysis

Urgent Start PD vs. HD

Which option is better if someone “crashes” into dialysis? A retrospective study was done of 178 people who started dialysis urgently between January, 2013 and December, 2014. Those who started PD had far fewer complications in the first 30 days. HD patients had more bloodstream infections. Survival was about the same for both groups.

Read the abstract » | (added 2016-12-09)

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PD Catheter Fixation Works

Can we keep PD catheters in place? This study compared 152 people who were randomly divided into three groups. Group 1 had their PD catheters placed with traditional open surgery. Group 2 had a modified open surgery placement. Group 3 had open surgery with the PD catheter fixated to the lower abdominal wall, and a vertical tunnel. After 6 months, all of the PD catheters worked in the fixated group—a much higher rate than for Group 1. There were no significant differences in infection, bleeding, leakage, pain, hernia, or wound healing.

Read the abstract » | (added 2016-12-09)

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Systematic Review of Pregnancy on HD

A new review summarizes 101 full papers and 25 abstracts and addresses the promise of successful pregnancy if enough HD is given.

Read the abstract » | (added 2016-11-10)

Tags: Hemodialysis

The HEMO Study Returns with a New Message

“An index only on the basis of urea does not provide a sufficient measure of dialysis adequacy,” finds yet another reanalysis of the by-now-ancient HEMO study data. Looking only at small uremic solutes—even non-urea wastes—did not predict all-cause mortality. Doing HD just three times a week made it impossible to remove enough solutes to matter.

Read the abstract » | (added 2016-11-10)

Tags: Hemodialysis

Time Matters: HD Kt Dose , Hospitalization, and Death

Does adding more HD benefit patients? Yes, finds a Fresenius study of 6,129 patients in Spain. There as a progressive increase in the risk of death for patients who were below the target Kt, and as Kt rose to reach and exceed the target, the risk declined, as did the risk of hospitalization. “Thus, prescribing an additional 3 L or more above the minimum Kt dose could potentially reduce mortality risk, and 9 L or more reduce hospitalization risk,” noted the authors.

Read the abstract » | (added 2016-11-10)

Tags: Hemodialysis

Why Seniors Choose HD vs. PD

Older people may be equally suited for PD or HD, so what guides their choice? In an interview study, PD was selected by those wanted convenience and a normal life. HD, on the other hand, was chosen by those who were afraid and wanted security. EDITOR’S NOTE: Of course patients are afraid! We need to help ease their fears before we educate them about their options.

Read the abstract » | (added 2016-11-10)

Tags: Hemodialysis

In the Netherlands, High-Dose HD Holds Up to Cost Scrutiny

Is high-dose HD cost-effective?  A new Dutch study finds that while conventional home HD (three treatments per week) may be the most cost-effective, since high-dose HD is twice as much treatment, "from a payer’s perspective, high dose HD should be offered as a home therapy to obtain its clinical benefits in a cost-effective manner."

Read the abstract » | (added 2016-10-13)

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US Home Dialysis Use by Racial and Ethnic Minorities

Are African Americans about 50% less likely to do home therapies across the entire US—or are certain states less well-represented than others?  An analysis of 369,164 Medicare fee-for-service dialysis patients was analyzed by state. African American patients were the least likely to use PD in every US region except Massachusetts. Across the US, all minorities were less likely to use home HD than Caucasians, but Asians were more likely to use home HD in the Midwest.

Read the abstract » | (added 2016-10-13)

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