Journal Watch - Hemodialysis

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  1. Systematic Review of Pregnancy on HD

    A new review summarizes 101 full papers and 25 abstracts and addresses the promise of successful pregnancy if enough HD is given.

    Read the abstract » | (added 11/10/2016)

    Tags: Hemodialysis

  2. The HEMO Study Returns with a New Message

    “An index only on the basis of urea does not provide a sufficient measure of dialysis adequacy,” finds yet another reanalysis of the by-now-ancient HEMO study data. Looking only at small uremic solutes—even non-urea wastes—did not predict all-cause mortality. Doing HD just three times a week made it impossible to remove enough solutes to matter.

    Read the abstract » | (added 11/10/2016)

    Tags: Hemodialysis

  3. Time Matters: HD Kt Dose , Hospitalization, and Death

    Does adding more HD benefit patients? Yes, finds a Fresenius study of 6,129 patients in Spain. There as a progressive increase in the risk of death for patients who were below the target Kt, and as Kt rose to reach and exceed the target, the risk declined, as did the risk of hospitalization. “Thus, prescribing an additional 3 L or more above the minimum Kt dose could potentially reduce mortality risk, and 9 L or more reduce hospitalization risk,” noted the authors.

    Read the abstract » | (added 11/10/2016)

    Tags: Hemodialysis

  4. Why Seniors Choose HD vs. PD

    Older people may be equally suited for PD or HD, so what guides their choice? In an interview study, PD was selected by those wanted convenience and a normal life. HD, on the other hand, was chosen by those who were afraid and wanted security. EDITOR’S NOTE: Of course patients are afraid! We need to help ease their fears before we educate them about their options.

    Read the abstract » | (added 11/10/2016)

    Tags: Hemodialysis

  5. PD Dose Needs Adjustment for Activity Level

    Is one PD Kt/Vurea level the same in a sedentary older person as it is in an active younger one?  NO, finds a new study that looked at energy expenditure in 148 PD patients. Adjusting Kt for resting energy use showed that women received less PD than men, younger people received less PD than older ones, and working people received less PD than unemployed ones—among other significant differences.

    Read the abstract » | (added 10/13/2016)

    Tags: Hemodialysis

  6. Personal Support Workers for Home HD

    Oh, Canada. The Canadians are out ahead of the US in virtually every dialysis parameter and they innovate constantly. Now, they have introduced a concept that CMS threw out with the bathwater in the 1980s—assisted home HD. A pilot project to dialyze six patients at home with personal support workers projected that costs would still be lower than for in-center HD. Phase 2 of the project includes 8 hospitals and 67 patients.

    Read the abstract » | (added 09/14/2016)

    Tags: Hemodialysis

  7. Considering Alternative Markers for Dialysis Dose

    A new review article looks at the impact of longer and/or more frequent, high-dose HD on dialysis adequacy—and inadequacy. Some uremic solutes come from nutrient intake and others don’t. For nutrient-based solutes, the authors suggest using inorganic phosphorus and protein-bound wastes as markers to develop new dose measures. For non-nutrient based middle molecules, they suggest beta-2-microglobulin measurement.

    Read the abstract » | (added 09/14/2016)

    Tags: Hemodialysis

  8. VIPs in Dialysis Modality Choice

    Whose opinion matters most to patients when it comes time to make a dialysis decision? In New Zealand, at least, it’s the nephrologist—even though respondents thought it would be predialysis nurses. In fact, a 1-point increase in nephrologist decisional power increased the rate of home therapies by 6.1%.

    Read the abstract » | (added 09/14/2016)

    Tags: Hemodialysis

  9. Exploding PD Myths

    Misconceptions about who will be a “good PD patient” have unnecessarily limited PD updake, increased transfers to in-center HD, and raised costs. Get the straight story!

    Read the abstract » | (added 09/14/2016)

    Tags: Hemodialysis

  10. French Patients on Daily HD

    Daily HD is relatively new to France—yet this study was able to include 753 patients who started on the therapy between 2003 and 2012. Two-thirds had switched to daily HD from another option. Younger patients (<64) had better survival (72.6% vs. 31%) and were more likely to receive a kidney transplant than older patients (>64).

    Read the abstract » | (added 08/09/2016)

    Tags: Hemodialysis