How much dialysis improves nutritional status?

Is short daily HD enough dialysis to appetite, food intake, and improve serum albumin levels? Maybe after a long time on dialysis, says a new study. But those who did nocturnal HD needed fewer binders.

Read more | (added May 24, 2013)

Impact of frequent HD on residual kidney function

We know that PD can help residual kidney function last longer. What happens with longer and/or more frequent HD? Results from the FHN trials suggest that residual kidney function loss may be faster with these options. [Editor's note: But, if more kidney replacement therapy is given, does it matter?]

Read more | (added May 24, 2013)

Phosphate is a blood vessel toxin

If blood phosphate levels are too high, the blood vessels can turn to stone—even in children. Heart damage from high phosphate levels can begin in pre-dialysis CKD. "Keeping serum P levels in the normal range reduces cardiovascular risk and mortality," say the authors. [Editor's note: nocturnal hemodialysis removes the most phosphate of any dialysis option.]

Read more | (added May 24, 2013)

More HD lowers C-reactive protein and boosts nutritional status

A study from Iran found that adding one standard HD treatment per week for 6 weeks significantly decreased C-reactive protein (a measure of inflammation), and increased serum albumin and BMI. The authors conclude that getting more HD may reduce the risk of cardiovascular events.

Read more | (added Apr 29, 2013)

Swedish patients who do home HD first have excellent survival

In Sweden, 128 patients who chose home HD as their first treatment and were under age 60 had 10-year survival of 75%, 20-year survival of 47%, and 30-year survival of 23%. For patients in this age group, getting a transplant did not further improve survival.

Read more | (added Apr 29, 2013)

Nocturnal home HD – no change in outcomes if a partner is needed

Do Canadian nocturnal home HD patients do worse if they need a partner to help them? No, says a study of 152 people, 47 who needed partners and 105 who could do their treatments unaided. Partner dependent patients were older, more likely to have diabetes, and had more comorbidities. But, there were no significant differences between groups in time to first hospitalization, technique failure, or survival.

Read more | (added Apr 29, 2013)

Patients with diabetes & renters may need extra help for home HD

Among 177 Canadian patients who started home HD training, 24 did not finish and 8 had technique failure in the first year. The strongest predictors of failure were diabetes or rented housing. These patients may need extra support to succeed.

Read more | (added Apr 29, 2013)

Daily HD does not harm accesses – a prospective, controlled study

A 4-year study was done of 51 on standard HD (3x4 hours) vs 23 on daily HD (6x3 hours). The standard HD group had 543.2 access procedures/1000 patient years; the daily group had 400.8. Adjusting for age, gender, diabetes, phosphorus level, and anemia, there were no significant differences in number of procedures or time to first access revision.

Read more | (added Apr 29, 2013)

New from Australia: Outcomes of extended HD (mainly done at home)

In a series of 286 people doing extended HD, 96% received their treatments at home, and 77% did them at night. Survival was 98% at 1 year, 92% at 3 years, and 83% at 5 years.

Read more | (added Feb 27, 2013)

Wearable and implantable kidney devices

The current standard in-center paradigm needs to change, say the authors of this review. Radically new approaches are needed to improve patient outcomes and quality of life. Two such approaches on the horizon are wearable and implantable devices.

Read more | (added Feb 27, 2013)

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