Home Dialysis Central
...everything you need to know about doing dialysis at home.
Journal watch: HD
Finally, data! Buttonhole Technique causes fewer fistula problems than site rotation
A new study compares 75 HD patients using the Buttonhole technique for fistula needles with 70 patients using the "standard" technique of "rope ladder" needle site rotation. Buttonhole users had fewer missed cannulations, bruises, and aneurysms, and needed less angioplasty. Infection precautions are vital: there was a higher infection rate.
Read more | (added Feb 24, 2011)
Access-challenged people on HD have a new HeRO
Running out of vascular access sites is no laughing matter. A new fully-implantable dialysis catheter helps solve the infection risk that occurs when a catheter goes through the skin and into a central vein. In a new study of 36 people, the Hemodialysis Reliable Outflow (HeRO) had infection rates similar to grafts.
Read more | (added Feb 24, 2011)
Nocturnal HD survival matches that of deceased donor transplant
A new study used data from two Canadian programs and the USRDS (1994 to 2006) and randomly matched each of 177 people doing nocturnal HD to three people who'd had transplants. During up to 12 years of follow-up, 14.7% of the nocturnal dialyzors died, vs. 14.3% of those who'd had deceased donor transplants, and 8.5% of those who'd had living donor transplants.
Read more | (added Feb 24, 2011)
Fresenius publishes home study of 2008K machine
A newly-released study follows 29 stable HD patients in-center for 6 months and then at home for 6 months on 2008H or K machines. While in-center, patients had 5.84 adverse events per 100 treatments—which dropped to just 3.34 events per 100 treatments at home.
Read more | (added Feb 24, 2011)
New study: Survival benefit for nocturnal HD
Researchers from the U.S. and Canada matched each of 94 people on nocturnal HD and 43 on short daily HD to 10 controls on standard HD. Even using the "proportional hazards model", they found a significantly lower risk of hospitalization and death on nocturnal, and a lower (but not significant) risk for daily, too.
Read more | (added Feb 24, 2011)
Dialysate regeneration for home HD
Dr. Ronco's been busy: he is also a co-author on an article this month about a system to use two activated carbon columns to regenerate dialysate.
Read more | (added Feb 24, 2011)
In-center nocturnal—another good option
Canada found that folks switched from standard in-center HD to nocturnal in-center HD (3 nights/week) used less EPO and had better sleep, quality of life, appetite, and energy. They also had fewer cramps.
Read more | (added Feb 24, 2011)
Switching from standard to nocturnal HD has many benefits
We bet you won't be surprised to learn that the 13 patients studied had much lower BP (with fewer drugs), higher hemoglobins (with fewer ESAs), better nutritional status, and lower calcium-phosphorus product. (PTH rose in some, though.)
Read more | (added Feb 24, 2011)
First report from the Frequent Hemodialysis Network studies!
There are two FHN studies. One compares 6-days-a-week in-center HD to 3-days-a-week. The other looks at 6-nights-a-week home nocturnal vs. 3 standard home HD treatments. So far, the study shows that more-frequent HD really is a LOT more dialysis—enough that the results should be able to prove whether more is truly better.
Read more | (added Aug 24, 2011)
Get drier: Live longer
A 3.5 year long study of 269 people on HD has found that folks who had more water removed from the blood (tested with a body composition monitor) lived significantly longer than those who stayed water-logged. (Drier is better, and doing longer and/or more frequent HD makes that possible.)
Read more | (added Feb 24, 2011)
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