Mineral balance in long HD

A metaanalysis from Canada of 21 studies concluded that keeping dialysate calcium ≥1.5 mmol/L for most patients on long/long-frequent HD prevents an increase in PTH levels and a decline in bone mineral density—without raising the risk of calcification. Adding phosphate to the dialysate for those with a low predialysis level or very low level makes sense.

Read the abstract » | (added 2013-08-22)

Tags:

PD Dialysate With Hydrogen May Protect Peritoneal Membranes

Over time, the peritoneum can be harmed by glucose degradation products in PD dialysate. In 6 patients, PD fluid with dissolved hydrogen significantly reduced oxidative stress vs. standard PD fluid.

Read the abstract » | (added 2013-07-17)

Tags:

Better Blood Sugar Control, Fewer PD Infections

No surprises here: blood sugar control matters in PD. A study that looked back at 183 PD patients found that those with poor control were more than twice as likely to have had an exit site or catheter infection as those with good control.

Read the abstract » | (added 2013-07-17)

Tags:

Itching? It May Be Due To High Calcium—Not Phosphorus

A study of 120 HD patients found high levels of serum phosphorus and parathyroid hormone (PTH) in those with and without dialysis itching (pruritus). But, the itchiest patients had significantly higher serum calcium levels.

Read the abstract » | (added 2013-07-17)

Tags:

How much dialysis improves nutritional status?

Is short daily HD enough dialysis to appetite, food intake, and improve serum albumin levels? Maybe after a long time on dialysis, says a new study. But those who did nocturnal HD needed fewer binders.

Read the abstract » | (added 2013-05-24)

Tags:

Phosphate is a blood vessel toxin

If blood phosphate levels are too high, the blood vessels can turn to stone—even in children. Heart damage from high phosphate levels can begin in pre-dialysis CKD. "Keeping serum P levels in the normal range reduces cardiovascular risk and mortality," say the authors. [Editor's note: nocturnal hemodialysis removes the most phosphate of any dialysis option.]

Read the abstract » | (added 2013-05-24)

Tags: Chronic kidney disease

Impact of frequent HD on residual kidney function

We know that PD can help residual kidney function last longer. What happens with longer and/or more frequent HD? Results from the FHN trials suggest that residual kidney function loss may be faster with these options. [Editor's note: But, if more kidney replacement therapy is given, does it matter?]

Read the abstract » | (added 2013-05-24)

Tags:

Swedish patients who do home HD first have excellent survival

In Sweden, 128 patients who chose home HD as their first treatment and were under age 60 had 10-year survival of 75%, 20-year survival of 47%, and 30-year survival of 23%. For patients in this age group, getting a transplant did not further improve survival.

Read the abstract » | (added 2013-04-29)

Tags:

New hope for stopping peritoneal fibrosis

There are vitamin D receptors all over the body. Low levels of vitamin D have been linked with severe fibrosis. This study gave mice peritoneal fibrosis and then looked at the impact of treatment with a vitamin D analog (22-oxacalcitriol). The treatment significantly prevented fibrosis and thickening of the peritoneum.

Read the abstract » | (added 2013-04-29)

Tags:

More HD lowers C-reactive protein and boosts nutritional status

A study from Iran found that adding one standard HD treatment per week for 6 weeks significantly decreased C-reactive protein (a measure of inflammation), and increased serum albumin and BMI. The authors conclude that getting more HD may reduce the risk of cardiovascular events.

Read the abstract » | (added 2013-04-29)

Tags: