Journal watch

If you can’t beat ‘em, zap ‘em!

Fibrils of amyloid can build up in the joints and soft tissues when too-little beta-2 microglobulin (B2m) is removed from the blood during dialysis. Longer and more frequent treatments remove more B2m. But what if we could remove fibrils that have already occurred? A new study suggests that laser treatments can destroy existing fibrils and slow the rate of new ones.

Read more | (added Feb 24, 2011)

Lower B2m levels predict better survival

More frequent—and especially longer—HD remove much more beta-2 microglobulin, a toxin that causes dialysis-related amyloidosis (DRA), with waxy protein deposits in bones, joints, and sometimes soft tissues. Since a new study has found that lower levels of B2m on dialysis predict survival, getting more dialysis is a plus!

Read more | (added Feb 24, 2011)

Poor sleep on standard in-center HD

Good sleep on dialysis improves survival. A new study compared sleep quality on standard in-center HD and a control group matched for age, sex, body mass index, and race. The in-center HD patients had significantly worse sleep.

Read more | (added Feb 24, 2011)

Treatment length matters (we knew that!)

Even when the same number of blood liters are processed, long, slow dialysis does a better job of removing toxins. In a study where patients on HD were dialyzed for 4, 6, or 8 hours, the longer treatments removed significantly more urea, creatinine, phosphorus, and beta-2 microglobulin. The authors conclude that Kt/V should not be the only measure of dialysis adequacy.

Read more | (added Feb 24, 2011)

Secondary arteriovenous fistulas: Converting prosthetic AV grafts to autogenous dialysis access

Dialysis fistulas tend to have fewer clots, infections, and hospital stays than grafts. Switching from a graft to a fistula was highly (90%+) successful after 2 years in a new study.

Read more | (added Feb 24, 2011)

Consistent aspirin use associated with improved AVF survival among incident HD patients in the DOPPS

A new paper from the Dialysis Outcomes & Practice Patterns Study (DOPPS) reports that people who took aspirin had significantly less fistula failure than those who didn't. (Talk to your doctor about whether a baby aspirin or an adult aspirin might benefit you.)

Take your vitamins

A new study finds that HD—with regular or high flux membranes—removes large amounts of water soluble vitamins.

Read more | (added Feb 24, 2011)

Travel time to HD predicts HRQOL, adherence, & death

A new paper from the Dialysis Outcomes and Practice Patterns (DOPPS) study of 20,994 patients reports that patents whose one-way travel to HD was longer than 60 minutes had significantly higher mortality and lower quality of life. Patients noted, "I feel as if it rules all my time." The authors suggest home dialysis as an option for those who live far from the nearest center.

Read more | (added Feb 24, 2011)

Daily HD survival compares to transplant

A study by Kjellstrand et. al. pooling data from 1006 short daily HD patient years (415 patients, both at home and in-center) found 2–3 times better survival than on standard in-center HD. In fact, survival with daily HD was similar to that of deceased donor transplant. (Interesting that no-one disputes that survival is better with transplant than standard HD—though patients are selected for it (just as for home HD) and no randomized controlled trial has been done.)

Read more | (added Feb 24, 2011)

No kidding: daily HD has better quality of life than standard in-center HD

Okay, we're not surprised to find that a meta-analysis of 17 papers comparing daily HD to standard HD found that folks using daily treatment had fewer access problems, better blood pressure control, less LVH, better anemia control, needed fewer phosphate binders—and had better quality of life.

Our sponsors

Home Dialysis Central is made possible through the generous annual contributions of our Corporate Sponsors. Learn more about becoming a Corporate Sponsor.