Journal watch: HD

Adsorptive column removes B2m

Too-high levels of B2m cause amyloidosis in people on dialysis, with joint and bone pain. In Japan, people dialyzed using the Lixelle S-15 adsorptive column had significantly less B2m in their blood after a year of 3x/week treatments. They were also stronger and had less joint pain.

Alternate-night HD improves bone minerals & blood pressure

Among 63 people in Australia who switched from standard HD to alternate-night HD, bone mineral balance and blood pressure improved after 18–24 months. Left ventricular mass did not improve, but remained stable.

Working fistula rate doubled with procedures

Are repeated fistula procedures worth it? Yes, says a new study of 294 people who had 347 fistulas made, with 736 procedures between them. While only 36.8% of fistulas were working on their own after 2 years, 77.8% were working 2 years later after procedures to fix them. (One patient had 11 interventions.)

Home dialysis boosts patient employment in Finland

A new study looked at employment results among 2,637 people ages 15 to 64 on dialysis or with kidney transplants in Finland. While just 19% of those on standard in-center HD were working, 39% of those on home HD, 40% of those with working transplants, and 44% on cycler PD were employed.

A new look at dialysis treatment length

There is increasing proof that dialysis treatments shorter than 4 hours are not long enough. A new paper reviews the literature knowing what we know now—and concludes that most people should get at least 4 hours per treatment.

Mucomyst does not prevent nephrogenic systemic sclerosis

A new study randomized 2,308 people at risk for kidney injury from contrast dye into two groups. One group was given acetylcysteine (Mucomyst®) by mouth, a strong antioxidant. The other group was given a placebo. Both groups had the same rate of kidney injury and need for dialysis.

Basing dialysis dose on REAL toxins

Dialysis "adequacy" is based on removing urea—a waste that is not all that toxic. A new article points out that finding and choosing wastes that truly are toxic could change the way we measure dialysis for the better.

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.

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