Home Dialysis Central
...everything you need to know about doing dialysis at home.
Journal watch
Somebody does it better
Like the U.S., Australia now requires folks with CKD to be educated about all treatment options. Unlike the U.S., they are following up to see if this is happening. A new study of 721 people with CKD found that 84% had options education before starting treatment. (We'd bet that the rates here are still far, far lower!)
Read more | (added Feb 24, 2011)
High transporters live just as long on cycler PD
In a study that followed 117 people who started PD in Korea, those who were older, or had diabetes or heart disease had poorer survival. But being a high transporter (wastes move quickly through the peritoneum but water removal is poor) did not reduce survival.
Read more | (added Feb 24, 2011)
Vitamin E-coated dialyzers may reduce inflammation
One cause of heart disease is a build-up of "free radicals" in the blood. Vitamin E is a potent antioxidant, which mops up free radicals. In Japan, Vitamin E-coated dialyzors have been linked with a need for less heparin and less anemia. Immune function seems better, too. Perhaps these will one day come to the U.S.?
Read more | (added Feb 24, 2011)
Rapid fluid removal during HD linked with heart damage and death
Short, fast, thrice weekly treatments are hard on the heart. Among 1,846 people on standard HD, those whose fluid removal was the slowest and most gentle were most likely to survive. Rates of fluid removal lower than 10 milliliters per hour per kilo were safest.
Read more | (added Feb 24, 2011)
15+ hours/week of short daily home HD boosts survival
Folks on standard HD have a 50% greater chance of dying on the day after the 2-day no-treatment weekend. Not so with short daily HD! A new study by Kjellstrand et al also finds that just being home boosted survival by 50%, and getting 15+ hours of treatment helped by 16%. Kt/V had no relationship with survival.
Read more | (added Feb 24, 2011)
Nocturnal HD? Watch those buttonholes!
Poor buttonhole technique led to a higher rate of hospital stays for sepsis (blood poisoning) among 63 people doing nocturnal in-center HD vs. 172 on standard HD. (Use a sterile tweezers to remove buttonhole scabs to reduce infection.)
Read more | (added Feb 24, 2011)
Survival with diabetes and kidney failure is better
Diabetes plus kidney failure is a tough blow. But, since 1980, survival for people with both health problems has more than doubled. And that was with standard in-center HD. Imagine how much better survival might be with more dialysis!
Read more | (added Feb 24, 2011)
Do surgeons get enough PD catheter training?
A new study suggests that the answer is "no." A survey of surgery programs found that 18% gave no training in PD catheters, though 48% felt it was important. Most put in 2 to 5 catheters. The good news: 62% of programs were willing to give fledgling surgeons more PD training.
Read more | (added Feb 24, 2011)
New saliva test measures testosterone levels
Kidney failure and low libido often go hand in hand. Low testosterone levels can be treated--if they are found. A new study finds that a morning saliva test gives results that compare well to blood tests.
Read more | (added Feb 24, 2011)
Less depression, short recovery with short daily HD
Depression dropped from 41% to 27% among the 128 dialyzors who took part in the NxStage FREEDOM study. AND, instead of taking nearly 8 hours to feel better after a treatment—it took just 63 minutes.
Read more | (added Feb 24, 2011)
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