Home Dialysis Central
...everything you need to know about doing dialysis at home.
Journal watch
Neutral pH PD fluid protects peritoneal membranes
Standard PD fluid may have an acidic pH and contain high levels of glucose degradation products (GDPs). Japanese researchers followed 12 patients using standard fluid and 12 using a neutral pH fluid with low GDPs. The low GDP group had less membrane fibrosis, blood vessel sclerosis, and build up of AGEs, and had higher ultrafiltration volume than the high GDP group.
Read more | (added Dec 19, 2012)
HbA1c levels do not predict survival in PD patients with diabetes
Researchers seeking a hemoglobin A1c target for PD patients with diabetes were not able to find any change in survival among 91 patients whose A1c levels were <6.5%, 6.5–8%, or >8%.
Read more | (added Dec 19, 2012)
Home HD for obese patients
In Australia, a 215 Kg man has successfully dialyzed at home for 8 years, after training by a program that has trained 23 obese (BMI >30) people to date. Home HD is a cost effective option with good outcomes in this group.
Read more | (added Nov 27, 2012)
CAPD improved outcomes in hard to treat CHF
In a study in Spain, 28 people with advanced congestive heart failure were treated with PD, while 34 controls were not. Sixteen months later, those who did PD were 40% more likely to survive.
Read more | (added Nov 27, 2012)
Biocompatible PD solution preserves residual kidney function
Researchers in Korea looked at the long-term impact of using Fresenius Balance® (FB) fluid vs. standard PD fluid. After 24 months, the GFR of patients using FB was twice that of those using standard fluid. Patients using FB also had better correction of metabolic acidosis, and higher levels of cancer fighting antigens.
Read more | (added Nov 27, 2012)
Mathematical modeling shows long, slow HD is better
Dropping the blood flow rate from 350 mL/min to 175 mL/min and dialyzing for 8 hours instead of 4 removes significantly more wastes—especially beta2 microglobulin, which causes amyloidosis.
Read more | (added Oct 25, 2012)
Home HD may be a good fit for obese patients
An Australian clinic has successfully trained 23 obese people (BMI >30) to do home HD between 2001 and 2009. Patients stayed on the treatment for an average of 43.7 months.
Read more | (added Oct 25, 2012)
Outcomes of extended-hours HD (mainly at home)
Among 286 people in Australia who did 24 hours or more of HD per week (96% at home), survival was 98% for 1 year, 92% for 3 years, and 83% for 5 years. Technique survival was 90% for 1 year, 77% for 3 years, and 68% for 5 years. This study did find higher rates of access problems with more frequent HD, but there was no control group.
Read more | (added Oct 25, 2012)
Long-term effects of daily HD on vascular access
Does more frequent use of a vascular access create problems for those who do short daily HD? A new 4-year prospective, randomized study of 77 people says NO. Patients did six 3-hour HD sessions per week (n=26) or three 4-hour sessions (n=51). There were fewer access procedures in the daily group (543.2 per 1000 patient years, vs. 400.8), though this difference was not significant. There was also no difference in time to first access revision or access failure.
Read more | (added Oct 25, 2012)
How to overcome barriers and set up a successful home HD program
Want to establish a home HD program, but don't know how to overcome the barriers? Look no further. This review article by giants in the field will help you get started.
Read more | (added Oct 25, 2012)
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