Journal Watch
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87 people on nocturnal home HD for 12 years had just 30% the mortality of standard HD
How does survival of people on nightly home HD compare to those in the USRDS? A single-center study of 87 people who got 40±6 hours a week of HD found that 79% lived 5 years, and 64% lived for 10 years—a mortality rate just 30% of the USRDS average. Higher levels of education and more hours of dialysis were the only factors independently linked with survival.
Read the abstract » | (added 2011-04-25)
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Oral adsorbents may help reduce levels of uremic toxins
The colon makes some wastes that are removed by the kidneys. So, drugs that keep these wastes from getting into the bloodstream could help keep them from building up in the body when the kidneys fail.
Read the abstract » | (added 2011-04-25)
Tags: Chronic kidney disease
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CAPD maintains residual kidney function better than APD
A new study followed 505 people on CAPD and 78 on APD for 3 years. The two groups had no major differences in residual kidney function (RKF) at baseline, but those on APD had a much higher risk of RKF loss in the first year. The highest risk of losing all RKF was found in those who had the highest GFRs at the study start.
Read the abstract » | (added 2011-04-25)
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Chemical ablation to correct recurrent secondary hyperparathyroidism post parathyroidectomy
Reoperation after a parathyroidectmy can be risky. In a study of 49 people, injecting ethanol (alcohol) into the gland, guided by ultrasound, helped to lower PTH levels without more surgery.
Read the abstract » | (added 2011-04-25)
Tags: Chronic kidney disease
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Fleet enemas can safely be added to nocturnal HD dialysate to boost phosporus levels
Nocturnal HD removes so much phosphorus that dialyzers may need supplements. Fleet® enemas are a low-cost, easy-to-obtain source of phosphorus. The amount of added phosphorus was predictable, and the product did not add bacteria or endotoxin to the dialysate.
Read the abstract » | (added 2011-04-25)
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Nocturnal HD makes pill regimens simpler but doesn't require less pill use
A study of 35 people on nocturnal home HD looked at how complex their pill regimens were, and how many pills they needed each day. After 2 years, they still needed just as many pills—but the regimen was much simpler. Dialyzors needed fewer BP pills and binders, but more vitamins and antibiotics.
Read the abstract » | (added 2011-04-25)
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Better PD technique survival in people with diabetes who use icodextrin
In the first randomized control trial using icodextrin in lieu of glucose for PD solution, 41 people with diabetic nephropathy were assigned one or the other. After 2 years, 71.4% of the icodextrin group was still doing PD, while only 45% who used glucose-based solution still did PD.
Read the abstract » | (added 2011-04-25)
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Long, slow HD removes more small & middle molecules than standard HD
A study that processed the same total blood and dialysate volume on two different time schedules looked at the importance of treatment time. Eleven people had a 4-hour and an 8-hour HD session, at least one week apart. Significantly more small and middle molecules were removed in the 8-hour treatments, though protein-bound solutes were not affected.
Read the abstract » | (added 2011-04-25)
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Simpler pill regimen needed by those using nocturnal home HD
Among 35 people who switched from standard in-center HD to nocturnal home HD, the number of pills per day did not drop—but the regimen was much simplified—and health-related quality of life was significantly improved.
Read the abstract » | (added 2011-03-30)
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AAKP's study of patient satisfaction with kidney education and dialysis (hint: not so good)
977 patients completed a 46-item survey asking about satisfaction with current treatment for kidney failure and education on a scale of 1–10 (with 1 low). Standard in-center HD rated 4.5. PD rated 5.2, home HD was 5.5, and transplant was 6.1. About 31% of participants felt the treatment options were not equally and fairly presented, and 32% had not been educated about home HD.
Read the abstract » | (added 2011-03-30)
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