Journal Watch
Human trial reports on wearable artificial kidney (WAK) in UK
The competition for better home HD gets even hotter! The December 2007 edition of Lancet includes an article about use of the WAK in 5 men and 3 women, who tried the device for 4–8 hours. There were no adverse heart, electrolyte, or acid-base events—though some access problems did occur, and dialysis itself is not yet optimal. It's still cool, though.
Read the abstract » | (added 2011-02-24)
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Study finds survival advantage for home hemo over in-center
A new retrospective Swiss study (Nephrology Dialysis Transplantation Jan 2005, 20:604-610) matched 58 home hemo (HHD) patients with 58 in-center patients on sex, age, length of time on dialysis, and cause of kidney failure. The researchers found better survival among the HHD patients at 5 (93% vs. 64%), 10 (72% vs. 48%), and 20 years (34% vs. 23%).
Read the abstract » | (added 2011-02-24)
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Wearable artificial kidney a step closer?
A company called National Quality Care presented its newly patented wearable artificial kidney (WAK) at the recent American Society of Nephrology meeting in Philadelphia. Invented by Dr. Victor Gura, the WAK is vastly smaller than current machines, and will permit 24/7 dialysis. Read more to learn how it will work.
Read the abstract » | (added 2011-02-24)
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Home hemo rates vary more than other modalities
A paper published in this month's Nephrology Dialysis Transplantation by Drs. Macgregor, Agar, and Blagg found more variation in the rates of home hemo between countries than any other type of dialysis. The authors concluded that "significant expansion of home HD is likely to be possible in most countries, and will be increasingly important as the impressive results of more frequent HD gain credence."
Read the abstract » | (added 2011-02-24)
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Kids & dialysis: daily and nocturnal hd have benefits
Imagine being a child and having to limit sodium, phosphorus, and fluids. A new article about pediatric HD reports outcomes from a program in France. Children using daily HD needed no fluid or diet limits except potassium, while those on nocturnal HD had no limits at all.
Read the abstract » | (added 2011-02-24)
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Predialysis education increases use of home therapies
In a randomized, controlled study done in Canada, of the patients who were assigned to see a 15-minute video on self-care dialysis, read booklets, and attend a 90-minute small group session, 82.1% chose a home dialysis option. Among the "usual care" group, only 50% did. (So, even usual care in Canada far surpasses what we do in the US!)
Read the abstract » | (added 2011-02-24)
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Intensive hemo helps heart health
After a year of short daily home HD 6 days/week or nocturnal home HD 3.5 nights/week, patients had no change in 24 hour blood pressure vs. controls on standard in-center HD. But those getting "intensive" (longer or more frequent) HD needed fewer blood pressure pills, their left ventricular mass decreased, and they had better phosphate control with fewer binders. Those who stayed on standard HD did worse in each area.
Read the abstract » | (added 2011-02-24)
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Nocturnal HD improves cognitive function
Fuzzy thinking on in-center HD? A new study suggests that nocturnal HD can help. Patients who switched to nocturnal HD had a 22% fewer cognitive symptoms and 32% better attention and working memory after 6 months.
Read the abstract » | (added 2011-02-24)
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Switching from standard to nocturnal HD improves vitamin D levels
In 35 patients who did nocturnal HD for 6 months or more, levels of active vitamin D rose significantly. The study patients had no diet limits, and their serum phosphorus levels fell after the switch from in-center HD. Normalizing phosphorus levels may help the body to produce more active vitamin D.
Read the abstract » | (added 2011-02-24)
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Nocturnal HD helps bone mineral status
Doing nocturnal home HD every other night helps bone minerals stay at more normal levels than standard treatments, say researchers from Australia in a new study. After 26 patients switched from standard (home) to nocturnal HD, their serum phosphorus and calcium-phosphorus products fell, most needed no binders, and bone mineral density was stable. Plus, blood vessel calcification improved or at least was stable in 87.5%.
Read the abstract » | (added 2011-02-24)
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