Home Dialysis Central
...everything you need to know about doing dialysis at home.
Journal watch
Australian nephrologists say PD first, then nocturnal HD
A lengthy survey of Australian nephrologists found strong agreement that long HD is a good option—most easily done at home, and that PD is a great first choice for dialysis. In fact, 34% of respondents said their clinic had a “PD First” policy.
Read more | (added May 23, 2011)
Eating more protein improves survival on PD
How much protein is enough on PD? In a study of 305 people on PD, getting 0.94 grams of protein per kilo of body weight per day was linked to much better survival. So if you weigh 68 kilos (150 lbs.), you’d need at least 64 grams of protein a day—about 2 and a quarter ounces. You can do that!
Read more | (added May 23, 2011)
Cycler PD has better outcomes than manual PD for those under age 65
Among 282 people on PD, younger people were much more likely to keep doing PD—and much more likely to survive—if they used a cycler.
Read more | (added May 23, 2011)
Long, slow HD removes more small & middle molecules than standard HD
A study that processed the same total blood and dialysate volume on two different time schedules looked at the importance of treatment time. Eleven people had a 4-hour and an 8-hour HD session, at least one week apart. Significantly more small and middle molecules were removed in the 8-hour treatments, though protein-bound solutes were not affected.
Read more | (added Apr 26, 2011)
Fleet enemas can safely be added to nocturnal HD dialysate to boost phosporus levels
Nocturnal HD removes so much phosphorus that dialyzers may need supplements. Fleet® enemas are a low-cost, easy-to-obtain source of phosphorus. The amount of added phosphorus was predictable, and the product did not add bacteria or endotoxin to the dialysate.
Read more | (added Apr 25, 2011)
Nocturnal HD makes pill regimens simpler but doesn’t require less pill use
A study of 35 people on nocturnal home HD looked at how complex their pill regimens were, and how many pills they needed each day. After 2 years, they still needed just as many pills—but the regimen was much simpler. Dialyzors needed fewer BP pills and binders, but more vitamins and antibiotics.
Read more | (added Apr 25, 2011)
Oral adsorbents may help reduce levels of uremic toxins
The colon makes some wastes that are removed by the kidneys. So, drugs that keep these wastes from getting into the bloodstream could help keep them from building up in the body when the kidneys fail.
Read more | (added Apr 25, 2011)
87 people on nocturnal home HD for 12 years had just 30% the mortality of standard HD
How does survival of people on nightly home HD compare to those in the USRDS? A single-center study of 87 people who got 40±6 hours a week of HD found that 79% lived 5 years, and 64% lived for 10 years—a mortality rate just 30% of the USRDS average. Higher levels of education and more hours of dialysis were the only factors independently linked with survival.
Read more | (added Apr 25, 2011)
More working-age dialyzors who chose PD kept their jobs, found a study of 102,104 people
Each year, half of all new dialyzors are working-age (<65), but most stop work after starting treatment. An analysis of USRDS data from 1992–2003 of people who were working 6 months before dialysis found that those most likely to work were: 1) white men ages 30–49; 2) those with glomerular, cystic, or urologic causes of ESRD; 3) those who chose PD first; 4) those with employer group health plans; 5) those who received ESAs.
Read more | (added Aug 22, 2011)
Switching from 3x4 hours HD to 6x3 hours reduced blood pressure, and improved hgb, albumin, & BMI
Healthy kidneys work 168 hours a week, but most people only get about 12 hours of dialysis. In this study, 11 people were switched to more frequent HD. After 12 months, they had significantly better blood pressure with fewer meds, higher hgb levels with lower ESA doses, higher albumin levels, lower dry weight, and better BMIs. Calcium-phosphorus products dropped significantly with no changes in binder doses.
Read more | (added Apr 25, 2011)
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