Journal Watch
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Mathematical modeling shows long, slow HD is better
Dropping the blood flow rate from 350 mL/min to 175 mL/min and dialyzing for 8 hours instead of 4 removes significantly more wastes—especially beta2 microglobulin, which causes amyloidosis.
Read the abstract » | (added 2012-10-25)
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Outcomes of extended-hours HD (mainly at home)
Among 286 people in Australia who did 24 hours or more of HD per week (96% at home), survival was 98% for 1 year, 92% for 3 years, and 83% for 5 years. Technique survival was 90% for 1 year, 77% for 3 years, and 68% for 5 years. This study did find higher rates of access problems with more frequent HD, but there was no control group.
Read the abstract » | (added 2012-10-25)
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Reasons why patients prefer more HD
An in-depth, interview study of 10 short daily or nocturnal HD patients in Canada found four main reasons why they liked their choice. 1) They felt better physically and mentally. 2) They felt more in control of their time. 3) They didn't feel "sick" and were more able to work. 4) They had the support they needed to succeed.
Read the abstract » | (added 2012-09-25)
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Are infections requiring hospitalization more common with PD or standard HD?
A study in Canada paired 910 people on PD with people on HD, matched by age, race, smoking, BMI, comorbid conditions, and lab data. After 2 years, researchers found that those on PD were more likely to be in the hospital for peritonitis—but less likely to have sepsis or pneumonia than those on standard HD.
Read the abstract » | (added 2012-09-25)
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A "self-locating" PD catheter
The Di Paolo self-locating PD catheter was tested in 20 patients in Italy. The researchers found no infections, and only 0.8% dislocated catheters—vs. 12% for Tenkhoff PD catheters.
Read the abstract » | (added 2012-09-25)
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Longer or more-frequent HD normalizes mortality patterns
It has long been known that those on PD have an equal chance of dying on any day of the week—while standard in-center HD are much more likely to die on a Monday (or Tuesday with Tue-Thu-Sat treatments). A new study looking at 14,636 Australian registry deaths found that those who got more than 3 standard in-center treatments per week or did home HD were no more likely to die on a Monday (or Tuesday) than any other day.
Read the abstract » | (added 2012-09-25)
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Short daily HD reduces left ventricular mass
The Frequent Hemodialysis Network trials found significant reductions in left ventricular mass (LVM)—with greater benefit for patients whose left ventricular mass was higher than normal at the start of the study.
Read the abstract » | (added 2012-08-16)
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PD in older patients
This study from Ireland looked at 148 people over age 50 who started PD between 1998 and 2008. The mean age was 63; most were over 70. The researchers found no difference in survival or technique survival by age, though older people did need a longer hospital stay to get started on PD.
Read the abstract » | (added 2012-08-16)
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Intensive HD survival 50% better than standard in-center HD
A new study comparing 420 patients in the International Quotidian Dialysis Registry with 338 matched standard in-center HD patients from the DOPPS study found that only 13% of patients who did at least 5.5 hours of HD at least three times a week died—vs. 21% who did standard treatments.
Read the abstract » | (added 2012-08-16)
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Mupirocin best for preventing PD exit site infections
A new double blind, controlled study of mupirocin antibiotic ointment vs. polysporin found that mupirocin came out on top. Twice as many patients who used polysporin had exit site redness and they were more likely to get fungal infections.
Read the abstract » | (added 2012-08-16)
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