Journal watch

Longer or more-frequent HD normalizes mortality patterns

It has long been known that those on PD have an equal chance of dying on any day of the week—while standard in-center HD are much more likely to die on a Monday (or Tuesday with Tue-Thu-Sat treatments). A new study looking at 14,636 Australian registry deaths found that those who got more than 3 standard in-center treatments per week or did home HD were no more likely to die on a Monday (or Tuesday) than any other day.

Read more | (added Sep 25, 2012)

Are infections requiring hospitalization more common with PD or standard HD?

A study in Canada paired 910 people on PD with people on HD, matched by age, race, smoking, BMI, comorbid conditions, and lab data. After 2 years, researchers found that those on PD were more likely to be in the hospital for peritonitis—but less likely to have sepsis or pneumonia than those on standard HD.

Read more | (added Sep 25, 2012)

A “self-locating” PD catheter

The Di Paolo self-locating PD catheter was tested in 20 patients in Italy. The researchers found no infections, and only 0.8% dislocated catheters—vs. 12% for Tenkhoff PD catheters.

Read more | (added Sep 25, 2012)

Metaanalysis: More HD boosts heart health

A metaanalysis of 46 studies concluded that switching from standard in-center HD to longer and/or more frequent HD significantly reduced left ventricular mass and improved blood pressure and the cardiac ejection fraction.

Read more | (added Aug 16, 2012)

Metaanalysis: Later dialysis start is better for HD

Starting dialysis at a lower GFR allows more time for access placement and options education. But the U.S. trend has been to start earlier. A new metaanalysis of 17 studies found that starting dialysis at a higher GFR was linked with a significantly higher risk of all-cause mortality—in HD, but not PD. The mortality risk was lower when GFR was calculated than when it was estimated.

Read more | (added Aug 16, 2012)

Intensive HD survival 50% better than standard in-center HD

A new study comparing 420 patients in the International Quotidian Dialysis Registry with 338 matched standard in-center HD patients from the DOPPS study found that only 13% of patients who did at least 5.5 hours of HD at least three times a week died—vs. 21% who did standard treatments.

Read more | (added Aug 16, 2012)

Short daily HD survival 13% better than than standard in-center HD

When 1,873 short daily home HD patients were matched with 9,365 standard in-center HD patients, those who did more frequent HD had a better chance of living longer.

Read more | (added Aug 16, 2012)

Nocturnal in-center HD survival about 50% better than standard in-center HD

A Fresenius study followed 946 patients doing 3x/week nocturnal in-center HD with 2,062 matched patients doing standard in-center treatments. After 2 years, 27% of those doing standard treatments had died, vs. 19% of those who did the longer, nocturnal treatments.

Read more | (added Aug 16, 2012)

Short daily HD reduces left ventricular mass

The Frequent Hemodialysis Network trials found significant reductions in left ventricular mass (LVM)—with greater benefit for patients whose left ventricular mass was higher than normal at the start of the study.

Read more | (added Aug 16, 2012)

Buttonhole needle technique causes less bleeding, pain

A small study in Thailand (21 patients) has found that stopping bleeding after removing dialysis needles takes less than half as long with the Buttonhole technique (4.19 +/- 1.66 mins) than with the rope ladder technique (9.12 +/- 2.36 mins), and causes significantly less pain.

Read more | (added Aug 16, 2012)

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