Nocturnal in-center HD comes to Slovenia

Only a few handfuls of US clinics offer nocturnal in-center HD. Now, Slovenian researchers report their experience of switching 10 patients from "standard" (4-5 hours!) in-center treatments to thrice weekly 8-hour long nighttime ones. With almost twice as much dialysis per week, mean predialysis creatinine and urea dropped significantly, as did mean dry weight. Six of the ten were able to stop taking phosphate binders, and one more patient had a dose reduction—and phosphate was added to the dialysate for three patients. There were no major changes in predialysis blood pressure, calcium or potassium levels, mean ultrafiltration, hemoglobin, or EPO dose (Editor's note: perhaps because standard HD in Slovenia is longer, and because the nocturnal treatments were only three times per week).

Read the abstract » | (added 2013-10-02)

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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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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

Modality choice is a factor in AV fistula creation

Canadian researchers compared the predialysis modality preferences of 508 people to their actual modality, and looked at their vascular accesses. The chance of having a fistula was much less in those who chose PD but started HD (39%), or who made no choice (50%), than in those who preferred HD and started on HD (79%).

Read the abstract » | (added 2012-12-19)

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Improve PD uptake by addressing misconceptions

In Singapore, interviews with predialysis patients and their families, people on dialysis, and health care professionals were done to explore how a treatment option choice is made. Fear of PD, daily commitment to PD, and misperceptions of PD were barriers that kept people from choosing the option. Patients were strongly influenced by other patients and wanted to hear what day-to-day life would be like before making a choice.

Read the abstract » | (added 2012-12-19)

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Predialysis education increases use of home therapies

In a randomized, controlled study done in Canada, of the patients who were assigned to see a 15-minute video on self-care dialysis, read booklets, and attend a 90-minute small group session, 82.1% chose a home dialysis option. Among the "usual care" group, only 50% did. (So, even usual care in Canada far surpasses what we do in the US!)

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

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