Better nutrition with nocturnal HD

A new study found better appetites, more energy, and higher protein intake in people doing 6 nights/week nocturnal HD. Even though they ate more foods high in phosphorus, their blood levels stayed good without binders. They were able to drink more fluids, too.

Read more | (added Feb 24, 2011)

Nocturnal HD improves bone mineral levels

Yes, we knew this—but this time, it's a randomized controlled trial of nocturnal (6 nights/week) vs. standard in-center HD (3 times/week). Compared to standard HD, those doing nocturnal had lower phosphorus—even without binders—lower PTH levels, and lower calcium-times-phosphorus products.

Read more | (added Feb 24, 2011)

To reduce inflammation: Get rid of your HD catheter

Even with no infection, an HD catheter can still trigger inflammation. In a new study, people who got a fistula and had a catheter removed had an 82% lower c-reactive protein (CRP) level 6 months later. Those who kept the catheter had a 16% higher CRP.

Read more | (added Feb 24, 2011)

The WAK is back…

The wearable artificial kidney (WAK) is still in development. In this most recent article, the developers have learned that a pulsing, rather than steady, flow of dialysate improves clearance of wastes. Activated charcoal is used to absorb Beta-2 microglobulin (which can cause dialysis-related amyloidosis). A dialyzer with a larger surface area and higher dialysate pH are also being tested.

Read more | (added Feb 24, 2011)

Nocturnal HD protects blood vessels

Damage to smooth muscle cells may be one reason why people on standard in-center HD tend to have more clogged and calcified arteries. In 15 patients studied before and after switching from standard HD to nocturnal HD, there was better smooth muscle growth and less cell death on nocturnal. (Blood pressure, PTH levels, and phosphorus levels improved, too.)

Read more | (added Feb 24, 2011)

Nocturnal HD normalizes smooth muscle cells

Blood vessel calcification is an all-too-common problem among people on dialysis. On standard HD, fewer smooth muscle cells grow inside the blood vessels, and more of them die. Switching from standard to nocturnal restored normal cell growth—and also lowered blood pressure, and PTH and phosphate levels.

Read more | (added Feb 24, 2011)

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)

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