Straight talk: Improve CKD outcomes by prescribing better dialysis

Longer or more-frequent treatments, better access choices, ultrapure water, and better removal of fluid and toxic middle molecules could improve survival on dialysis, say researchers.

Read the abstract » | (added 2011-02-24)

Tags: Chronic kidney disease

Toronto: 61% of dialysis patients went home

Imagine what US dialysis would look like if we could do what our neighbors do! A study of 486 people with CKD from 2001-2007 found that, of the 153 who started dialysis, most went home (79 on PD, 15 on home HD). Why (or why not)?

Read the abstract » | (added 2011-02-24)

Tags: Chronic kidney disease

Somebody does it better

Like the U.S., Australia now requires folks with CKD to be educated about all treatment options. Unlike the U.S., they are following up to see if this is happening. A new study of 721 people with CKD found that 84% had options education before starting treatment. (We'd bet that the rates here are still far, far lower!)

Read the abstract » | (added 2011-02-24)

Tags: Chronic kidney disease

Vytorin® reduced heart attacks & strokes in those with CKD

In a study of more than 9,000 people, the cholesterol-lowering (statin) drug Vytorin significantly reduced the risk of heart attacks and strokes. One-third of those who took part were on dialysis; the rest had stage 3,4, or 5 CKD.

Read the abstract » | (added 2011-02-24)

Tags: Chronic kidney disease

ESAs save lives and dollars in CKD

Erythrocyte-stimulating agents like EPOGEN, Procrit, and Aranesp have gotten a bad rap lately. A new study looked back at data from 8,188 patients ages 15 or over with CKD and anemia who were enrolled in health plans. The findings: the 14.6% who received ESAs were less likely to be hospitalized or go to the ER, took longer to reach dialysis, were less likely to die in the hospital—and their care cost less, too.

Read the abstract » | (added 2011-02-24)

Tags: Chronic kidney disease

TPA reduces HD catheter infections by 50%

Heparin is put into HD catheters after each use to prevent blood clots. Researchers replaced it with a clot-busting drug used for strokes—TPA—at one treatment per week. The new routine reduced catheter infections. (Hmmm. Is heparin sterile? What if TPA was used at ALL HD treatments?)

Read the abstract » | (added 2011-02-24)

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More people are being told about PD

In 1997, the DMMS Wave 2 study found that fewer than 25% of people with kidney failure were told about PD. A new survey of people surveyed from 2005–2007 found that 61% were told—though just 10.9% of them chose PD. Still—major progress!

Read the abstract » | (added 2011-02-24)

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It's never too late to educate

Each year, many people need dialysis within just a few weeks or months of learning that their kidneys have failed. A new Canadian study found that among 228 such people who were educated by a nurse while in the hospital, 49 (21.4%) chose PD, and 22 (9.6%) chose home HD. (In the US, fewer than 8% are home.)

Read the abstract » | (added 2011-02-24)

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Dialysis at a crossroads: 50 years later

The well-known and highly respected nephrologists who sent a letter to CMS about how to improve dialysis care—with longer and/or more-frequent treatments—have written an article summing up their thoughts.

Read the abstract » | (added 2011-02-24)

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Yet another call for PD first

Doctors at the University of Missouri have written an article noting that PD is under-used, and suggest ways to promote PD as a first dialysis option. Good idea!

Read the abstract » | (added 2011-02-24)

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