Journal watch: HD

Home HD and mortality risk in Australia and New Zealand

Researchers analyzed data from 26,016 patients in the ANZDATA registry (856,007 patient-months) to see if home HD helped people live longer. Compared to standard in-center HD, those on standard (3x/week), more-frequent, or nocturnal home HD were about twice as likely to survive.

Review: What do we know now about more-frequent HD?

Studies have shown since the 1960s that more-frequent dialysis improves outcomes. The recent Frequent Hemodialysis Network trials confirmed these findings. This article reviews the data.

Nocturnal HD helps people grow cells that lead to healthy new blood vessels

Growth of new blood vessels is impaired with standard in-center HD. The cells that grow blood vessels don't work as well as they should, because waste levels in the blood are still too high, even with treatment. But, nocturnal HD is another story. With the blood much cleaner, there was significantly better cell function.

Pilot results of a wearable artificial kidney

Eight people on HD have now tested a new wearable HD device for 4-8 hours. Fluid was removed with no heart problems, and some wastes were removed as well. The safety devices for needle disconnection and clotting worked quickly. A step forward!

Risk factors linked to renal cell cancer (RCC) after long-term dialysis

RCC occurs at higher rates in those who have been on dialysis for many years. If you know the risk factors, you can ask for screening. Those at highest risk in a large study were men; older people; ESRD caused by an obstruction, FSGS, or tuberous sclerosis; and those whose kidneys grew new cysts.

Better survival on home HD than PD in England and Wales

A study from the UK compared 225 people on home HD from 1997 to 2005 with age and sex matched people on PD and standard HD. Those on home HD lived significantly longer than those on PD—even when the researchers adjusted for those who received transplants or were on the wait list.

Aspirin use is linked with better HD graft survival

Taking a low-dose aspirin each day led to about 30% better graft survival in a year-long study.

New model using routine lab tests can predict progression to kidney failure

Researchers looked at data from a total of 8,391 people with stages 3–5 CKD to see if lab test results could predict who would progress to end-stage. A model that included age, sex, GFR, and protein in the urine worked best.

Bone loss in women on dialysis—the role of estrogen

A study of 112 postmenopausal women on HD in Japan found that estrogen was closely linked to bone density. The authors conclude that taking estrogen may help prevent bone loss throughout life in women on HD.

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