Journal Watch
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Daily HD does not harm accesses – a prospective, controlled study
A 4-year study was done of 51 on standard HD (3x4 hours) vs 23 on daily HD (6x3 hours). The standard HD group had 543.2 access procedures/1000 patient years; the daily group had 400.8. Adjusting for age, gender, diabetes, phosphorus level, and anemia, there were no significant differences in number of procedures or time to first access revision.
Read the abstract » | (added 2013-04-29)
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Patients with diabetes & renters may need extra help for home HD
Among 177 Canadian patients who started home HD training, 24 did not finish and 8 had technique failure in the first year. The strongest predictors of failure were diabetes or rented housing. These patients may need extra support to succeed.
Read the abstract » | (added 2013-04-29)
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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)
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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)
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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)
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Icodextrin metaanalysis – no impact on patient survival
Australian researchers analyzed 11 studies of icodextrin vs. glucose PD fluid (1222 patients). Icodextrin did help reduce fluid overload without harming residual kidney function. But, it did not help reduce peritonitis, technique failure, or other adverse events. And, patients who used icodextrin did not live any longer.
Read the abstract » | (added 2013-04-29)
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Nocturnal home HD – no change in outcomes if a partner is needed
Do Canadian nocturnal home HD patients do worse if they need a partner to help them? No, says a study of 152 people, 47 who needed partners and 105 who could do their treatments unaided. Partner dependent patients were older, more likely to have diabetes, and had more comorbidities. But, there were no significant differences between groups in time to first hospitalization, technique failure, or survival.
Read the abstract » | (added 2013-04-29)
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Alert: Icodextrin PD fluid can mask hypoglycemia
A case report of an 80 year old man in the emergency room highlights the need for healthcare providers to be aware of the impact of icodextrin PD fluid on blood sugar. Handheld glucose meters can overestimate blood sugar. A lab test can verify blood sugar if symptoms of hypoglycema are present and the glucometer reading is normal.
Read the abstract » | (added 2013-02-27)
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Wearable and implantable kidney devices
The current standard in-center paradigm needs to change, say the authors of this review. Radically new approaches are needed to improve patient outcomes and quality of life. Two such approaches on the horizon are wearable and implantable devices.
Read the abstract » | (added 2013-02-27)
Tags: Chronic kidney disease
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Home HD beliefs of patients and care partners in Italy
Home HD is underused in Italy. Interviews found three positive themes: flexibility/freedom, comfort in familiar surroundings, and altruistic motivation to be an example for others. Four negative themes were also found: disrupted sense of normality, family burden, housing constraints, and healthcare by "professionals", not "amateurs".
Read the abstract » | (added 2013-02-27)
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