Why nocturnal HD reduces sudden cardiac death

Prolonged QTc intervals between heartbeats increases the rate of sudden cardiac death in people whose kidneys work. In an ECG study, patients who did nocturnal HD had shorter QTc intervals—even if those intervals were long before dialysis and even before changes to the left ventricle.

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

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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)

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New Vwing device helps start Buttonholes

A new, surgically implanted device used for 387 cannulations over 6 months in 9 patients was successful 94% of the time. But, standard cannulation for the other needle only worked 77% of the time. This device may help with difficult to cannulate fistulas.

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

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Wearable and implantable artificial kidneys

Thrice weekly in-center HD for 4 hours or less is a paradigm that must change to improve patient outcomes. But longer and/or more frequent treatments are not practically available to the total dialysis population. Thus, radical new approaches are needed—like wearable devices or implantable ones.

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

Tags: Chronic kidney disease

Predialysis patient education boosts use of PD

In a 4-year period, 227 patients attended a CKD education program. Compared to a control group who did not attend, the educated patients were almost twice as likely to choose PD (54.3% vs. 28%).

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

Tags: Chronic kidney disease

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)

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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)

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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)

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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)

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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