Journal Watch - Hemodialysis

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  1. Frequent HD in Children

    Does 5x/week in-center HD benefit children more than 3x/week treatments? A multicenter pilot followed 8 children with a median age of 16.7 years. Among the 6 patients who completed two study periods, 5 had a sustained 10% or more decrease in systolic BP or antihypertensives during the more frequent treatments. Reimbursement and time burdens are challenges.

    Read the abstract » | (added 04/12/2017)

    Tags: Hemodialysis

  2. PD vs. Standard HD for People with Cirrhosis

    For cirrhotic people with kidney failure, data abstraction from the U.S. Nationwide Inpatient Study between 2005 and 2012 compared outcomes with PD and standard in-center HD. In-hospital mortality for those with ascites was significantly less with PD. In addition, PD hospital stays were shorter and costs were lower. Yet, just 1.7% of the sample was using PD.

    Read the abstract » | (added 04/12/2017)

    Tags: Peritoneal Dialysis, Hemodialysis

  3. Pregnancy on PD—at 42: It’s Not Impossible

    While research shows that the chance for a pregnant woman on dialysis to have a healthy baby seems to be best with 36+ hours of HD per week, a 42-year old Malaysian woman had a full-term baby with no change to her CAPD prescription.

    Read the abstract » | (added 04/12/2017)

    Tags: Peritoneal Dialysis, Hemodialysis

  4. Results of a Metaanalysis of Nocturnal vs. Standard HD

    Researchers who looked at 28 studies of 22,508 patients found a mixed bag: comparable side effects and mortality between nocturnal and standard HD, less hospitalization with standard HD—but better heart health and physical quality of life with nocturnal HD, with fewer blood pressure medicines needed.

    Read the abstract » | (added 03/09/2017)

    Tags: Hemodialysis

  5. And, Again: More HD Improves Quality of Life

    Data from the Frequent Hemodialysis Network (FHN) trials found that those who were randomized to frequent or nocturnal HD reported outcomes that included better results on a “feeling thermometer,” better general health, and shorter recovery time than for standard in-center HD.

    Read the abstract » | (added 03/09/2017)

    Tags: Hemodialysis

  6. Home HD: Cost-effective With Better Outcomes Than In-center

    A review of the patient-centered and economic impacts of home HD that included studies between 2000 and 2016 found better quality of life, flexibility, employment potential, and survival vs. hospital HD. Minority and low-income patients still have less access than others, which compounds their already-poor health outcomes. The authors found that home HD is cost-effective and the use of this option should be increased.

    Read the abstract » | (added 03/09/2017)

    Tags: Hemodialysis

  7. Does Frequent HD Boost Quality of Life? NO

    A new Canadian study randomized 200 patients to standard in-center HD (12-15 hours/wk; maximum of 18 hours) or extended HD (>24 hours/wk) for a year. Extended HD reduced phosphate and potassium levels and boosted Hgb, and patients took fewer BP meds and phosphate binders. However, health-related quality of life scores did not differ significantly between the groups.

    Read the abstract » | (added 02/08/2017)

    Tags: Hemodialysis

  8. Does Frequent HD Boost Quality of Life? YES

    As with nearly every other study, a new paper from the Frequent Hemodialysis Network trial looked at HRQOL among patients randomized to conventional vs. 6x/week HD (N=245) or 6x/week nocturnal vs. conventional home HD (N=87). After one year, patients who dialyzed more often had higher HRQOL than those on standard HD—and shorter recovery after each treatment.

    Read the abstract » | (added 02/08/2017)

    Tags: Hemodialysis

  9. Medicare Payment for Daily Home HD Varies Geographically

    According to Medicare claims data for in-center HD and home HD from 2009-2012, there were persistent variations in the home HD treatment claims paid by different Medicare contractors. Fortunately, these differences did not seem to affect whether clinics offered home HD.

    Read the abstract » | (added 02/08/2017)

    Tags: Hemodialysis

  10. More Hospital Readmissions with PD Than In-Center HD

    Those on PD have fewer routine clinic visits than those on standard in-center HD. This may help explain why a 10-year study of hospital discharges among 28,026 dialyzors in Canada found that 30-day readmission rates in PD patients were higher (7.1) than for matched patients doing standard in-center HD (6.0). Better care transitions may help.

    Read the abstract » | (added 02/08/2017)

    Tags: Hemodialysis, Peritoneal Dialysis