Journal Watch

  • Poor sleep on standard in-center HD

    Good sleep on dialysis improves survival. A new study compared sleep quality on standard in-center HD and a control group matched for age, sex, body mass index, and race. The in-center HD patients had significantly worse sleep.

    Read the abstract » | (added 2011-02-24)

  • Consistent aspirin use associated with improved AVF survival among incident HD patients in the DOPPS

    A new paper from the Dialysis Outcomes & Practice Patterns Study (DOPPS) reports that people who took aspirin had significantly less fistula failure than those who didn't. (Talk to your doctor about whether a baby aspirin or an adult aspirin might benefit you.)

    Read the abstract » | (added 2011-02-24)

  • Secondary arteriovenous fistulas: Converting prosthetic AV grafts to autogenous dialysis access

    Dialysis fistulas tend to have fewer clots, infections, and hospital stays than grafts. Switching from a graft to a fistula was highly (90%+) successful after 2 years in a new study.

    Read the abstract » | (added 2011-02-24)

  • New study: Survival benefit for nocturnal HD

    Researchers from the U.S. and Canada matched each of 94 people on nocturnal HD and 43 on short daily HD to 10 controls on standard HD. Even using the "proportional hazards model", they found a significantly lower risk of hospitalization and death on nocturnal, and a lower (but not significant) risk for daily, too.

    Read the abstract » | (added 2011-02-24)

  • Daily HD survival compares to transplant

    A study by Kjellstrand et. al. pooling data from 1006 short daily HD patient years (415 patients, both at home and in-center) found 2–3 times better survival than on standard in-center HD. In fact, survival with daily HD was similar to that of deceased donor transplant. (Interesting that no-one disputes that survival is better with transplant than standard HD—though patients are selected for it (just as for home HD) and no randomized controlled trial has been done.)

    Read the abstract » | (added 2011-02-24)

  • Nocturnal HD survival matches that of deceased donor transplant

    A new study used data from two Canadian programs and the USRDS (1994 to 2006) and randomly matched each of 177 people doing nocturnal HD to three people who'd had transplants. During up to 12 years of follow-up, 14.7% of the nocturnal dialyzors died, vs. 14.3% of those who'd had deceased donor transplants, and 8.5% of those who'd had living donor transplants.

    Read the abstract » | (added 2011-02-24)

  • Travel time to HD predicts HRQOL, adherence, & death

    A new paper from the Dialysis Outcomes and Practice Patterns (DOPPS) study of 20,994 patients reports that patents whose one-way travel to HD was longer than 60 minutes had significantly higher mortality and lower quality of life. Patients noted, "I feel as if it rules all my time." The authors suggest home dialysis as an option for those who live far from the nearest center.

    Read the abstract » | (added 2011-02-24)

  • No kidding: daily HD has better quality of life than standard in-center HD

    Okay, we're not surprised to find that a meta-analysis of 17 papers comparing daily HD to standard HD found that folks using daily treatment had fewer access problems, better blood pressure control, less LVH, better anemia control, needed fewer phosphate binders—and had better quality of life.

    Read the abstract » | (added 2011-02-24)

  • On dialysis and want a baby? Think about nocturnal HD

    The numbers are very small—but in a new study, 5 women ages 31–37 had 7 pregnancies between them and 6 live infants while receiving 43–53 hours of nocturnal HD per week. Two of the infants were small for gestational age, and one was premature. None of the women (from Toronto) had conceived while doing standard HD.

    Read the abstract » | (added 2011-02-24)

  • More blood pressure meds + standard HD doesn't = better BP

    Both daily and nocturnal HD can aid blood pressure control and reduce the need for BP meds. But do more BP meds on their own help blood pressure in patients on standard therapy? A new study says NO. Among 106 ESRD patients, those who took 4+ BP pills had no better blood pressure than those who took 2–3 or 0–1.

    Read the abstract » | (added 2011-02-24)