Journal Watch - Nocturnal Hemodialysis
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In-center Nocturnal HD: Fewer Complications than PD in Patients with PKD
An analysis that matched PDK patients who did conventional HD (26) or PD (26) to in-center nocturnal HD (NHD; 13) found no significant difference in mortality—but after a median follow up of 5.5 years, NHD had significantly fewer complications than PD—and higher serum albumin levels as well.
Read the abstract » | (added 2019-12-10)
Tags: Polycystic Kidney Disease, Conventional Dialysis, In center Nocturnal HD, Nocturnal Hemodialysis, Mortality
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What Makes Home HD Patients Reach for On-Call Support?
A 4-month prospective observational study analyzed the reasons why 58 home HD patients called the on-call nurse or technician. Most calls to nurses were made for clinical issues or machine set-up or alarm questions, some of which required a technician. Most of the technician calls were for machine malfunction, set-up and alarms, or water treatment. Read the abstract.
Read the abstract » | (added 2018-10-12)
Tags: Home Hemodialysis, Independent Hemodialysis, Nocturnal Hemodialysis, Short Daily Hemodialysis
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Nocturnal Home HD Boosts Patient Employment Compared to PD
A year-long study comparing 20 alternate-night nocturnal home hemodialysis patients to matched 81 CAPD patients in Hong Kong found 80% employment among the nocturnal HD patients (who were 5 years younger) and just 33.3% among PD patients. The nocturnal patients also used fewer phosphate binders. Read the abstract.
Read the abstract » | (added 2017-11-13)
Tags: Chinese, Nocturnal Hemodialysis, Employment Rate, Incident, Peritoneal Dialysis
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Barriers to Intensive HD in Pediatrics
Why don’t more people choose intensive hemodialysis? Responses to a survey by 134 of the 221 pediatric dialysis centers in the International Pediatric Dialysis Network found that more than 2/3 were aware of evidence supporting the benefits of intensive HD and half believed it produced the best outcomes (just 2% favored conventional HD). Key barriers included lack of funding and staff, with lack of expertise and motivation as minor factors. Read the abstract.
Read the abstract » | (added 2017-11-13)
Tags: Children, Financial Barriers, Home Dialysis, Intensified Hemodialysis, Nocturnal Hemodialysis
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Are we finally nearing the end of Kt/V?
We have been vocal critics of Kt/V on Home Dialysis Central since the start—and now we are not alone. A new paper finds that Kt/V is not a good fit for short daily or long nocturnal treatments, to the point where, “urea kinetics are hardly if at all representative for those of other solutes with a deleterious effect on morbidity and mortality of uremic patients.”
Read the abstract » | (added 2015-07-08)
Tags: Nocturnal Hemodialysis
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FHN finding: Frequent and/or Nocturnal HD lowers blood pressure
In the Frequent Hemodialysis Network trials, those randomized to short daily HD had systolic BP an average of 7.7 points lower than those in the standard HD group. Diastolic BP came down an average of 3.9 points. Fewer BP meds were needed. Those who did nocturnal HD had systolic BP an average of 7.3 points lower, and diastolic an average of 4.2 points lower.
Read the abstract » | (added 2015-02-10)
Tags: Nocturnal Hemodialysis
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More protein intake with nocturnal HD—but no change in body composition
Among 11 people doing nocturnal HD, protein intake increased significantly compared to matched standard in-center HD controls. But, one year later, total body mass, fat-free mass, and fat mass did not change.
Read the abstract » | (added 2014-12-09)
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Nocturnal HD reduces blood endotoxin levels
Endotoxin drives inflammation throughout the body. Which type of HD is most effective at reducing endotoxin in the blood? This study compared standard in-center HD (n=56) to short daily HD (n=20) and nocturnal HD (N=10). Endotoxin levels were highest when ultrafiltration rates were highest (standard in-center HD) and lowest among those doing nocturnal HD.
Read the abstract » | (added 2014-12-09)
Tags: Nocturnal Hemodialysis
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Nocturnal home HD boosts hemoglobin level and reduces ESA use
Every other night nocturnal home HD (NHHD) was compared to standard in-center HD in a small study. Among the 23 people using NHHD, Hemoglobin increased by about 2 g/dL after 2 years (P<0.001), while ESA dose dropped by just over 50% (P<0.001), and 26% were able to stop ESAs. Among the 25 people doing standard HD, hemoglobin levels dropped by almost 2 g/dL (P = 0.007), and ESA dosage increased (P<0.001).
Read the abstract » | (added 2014-10-07)