Journal Watch - Hemodialysis
Home Dialysis Care Experience instrument
A new patient-reported experience measure for PD and home HD has been developed, based on a structured literature review, focus groups, interviews, and then cognitive testing. The 26-item measure covers 16 domains in six areas: communication and patient education, care team concern and helpfulness, care team proficiency, patient-centered care, care coordination, and personalized care.
Read the abstract » | (added 2021-04-16)
International Use of HD—Including Home HD
A new survey of stakeholders in 182 countries (with respondents from 160 countries) found a use rate for HD of 298.4 per million. Among incident dialysis patients, the HD rate was 98.0. Standard in-center HD was available among 27% of low-income countries (and these patients paid more of the costs); home HD was available in 36% of high-income countries. Monitoring of patient-reported outcomes was done in 61% of countries, while 60% monitored bone minerals and patient survival, and 51% monitored technique survival. Just 5% of countries initiated patients on HD with arteriovenous access.
Read the abstract » | (added 2020-09-11)
Starting with PD Better than Switching to it from HD
A metaanalysis comparing patients who started with PD to those who began HD and then switched to PD after 3 months found significantly better overall and technique survival in the PD first group. There were no significant differences in the peritonitis rate.
Read the abstract » | (added 2020-07-10)
The Q-Cohort Study: More Dialysis, Less Risk of Cancer
Uremic toxins increase cancer risk. In a study of 3,450 HD patients followed for 4 years, patients were divided into quartiles based on their baseline Kt/V. Four-year survival dropped linearly along with Kt/V. Every 0.1 increase in Kt/V reduced the risk of cancer death by 8%.
Read the abstract » | (added 2020-02-19)
Transplant Survival Better After PD Than Standard In-center HD
Is there an advantage to PD over standard in-center HD for transplant graft survival? YES, suggests a 15-year retrospective study of 2,277 transplant recipients. Those who did PD prior to transplant were 34.5% more likely to survive, and had less frequent rejection. Living donor kidneys did best among patients who received transplants before starting dialysis—or did PD.
Read the abstract » | (added 2019-11-16)
PD vs. Standard In-center HD for Quality of Life
A 24-month observational study compared 45 standard HD and 30 PD patients, and assessed their quality of life, cognitive function, and depression at study start and every 12 months. Over the 24 months, PD patients had significant improvement in physical and social well-being—while HD patients stayed the same. Cognitive function held steady in PD patients—but declined in HD patients. Depression increased among those on standard HD—but not those on PD.
Read the abstract » | (added 2019-11-16)
Left Atrial Remodeling Not Found After 1 Year of Nocturnal HD
While left ventricular mass has been shown to regress with intensive HD, the same does not seem to hold true for the left atrium, nor did the ejection fraction improve, finds a new study of 37 patients switched from conventional HD. Read the abstract.
Read the abstract » | (added 2018-09-10)
PD vs. In-Center HD for Stroke Risk
A systematic review of 15 cohort studies totaling nearly 1.3M ESRD patients concludes that PD had a significantly lower (16%) risk of hemorrhagic stroke, though the risks of other types of strokes were comparable.
Read the abstract » | (added 2018-08-13)
Iron-based Binder Safe and Effective in PD
A study conducted with 84 PD patients compared sucroferric oxyhydroxide (n=56) to sevelamer (n=28). After a year, both groups had serum phosphate levels within the target range. The iron-based binder required fewer pills per day and resulted in fewer adverse events. Read the abstract.
Read the abstract » | (added 2017-11-13)
In-center nocturnal HD boosts lean body mass
Among 56 adults followed for a year, those who were randomly assigned to nocturnal in-center HD vs. standard treatments had higher, more stable interdialytic weights. The pattern of toxin removal suggests that the result is due to increases in lean body mass.
Read the abstract » | (added 2017-05-09)