Mortality patterns in PD & home HD differ from standard in-center HD

In the Australian dialysis database (ANZDATA), 4,298 deaths on PD and 10,338 on HD were analyzed for patterns. Patients who did PD, home HD, or in-center HD more than 3 days per week were equally likely to die on any day of the week. Not so for standard in-center HD patients: they were significantly more likely to die from heart-related reasons on Monday, after the 2-day no-treatment weekend.

Read the abstract » | (added 2013-02-27)

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New from Australia: Outcomes of extended HD (mainly done at home)

In a series of 286 people doing extended HD, 96% received their treatments at home, and 77% did them at night. Survival was 98% at 1 year, 92% at 3 years, and 83% at 5 years.

Read the abstract » | (added 2013-02-27)

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When choosing a treatment option, lifestyle is what matters to patients

A metaanalysis found 16 studies of how people with late-stage CKD choose what type of dialysis to do. Common elements included the life-or-death nature of ESRD; minimal intrusion of treatment into quality of life, autonomy, values, and sense of self; and making informed choices.

Read the abstract » | (added 2013-01-25)

Tags: Chronic kidney disease

Surgery to fix PD catheters in place is safe, effective

PD catheters that move around in the belly can be painful and may stop working. Korean doctors compared 22 PD catheters placed by a laparoscopic technique that fixed them in place to 32 placed by open surgery. The age and sex of both groups was the same, and the fixing technique took longer to do. But, 29 months later, the fixed catheters were much less likely to move (13.6% vs. 65.6%). Both techniques had the same catheter and patient survival.

Read the abstract » | (added 2013-01-25)

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What does glucose in PD fluid have to do with artery calcification?

Quite a bit, it appears. Among 50 people doing PD who did not have diabetes, about half had coronary artery calcification. Those who used more higher glucose PD fluids were more likely to have the problem, as were men with a history of heart disease, and those who did not get enough PD.

Read the abstract » | (added 2013-01-25)

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If at first you don't succeed with PD...it still costs less than in-center HD

A 4-year Canadian study has found that over a 3-year period, the cost of starting on PD and then switching to HD ($114,503) is still much less than doing standard in-center HD ($175,996). But starting and continuing PD is the lowest cost dialysis option ($58,724).

Read the abstract » | (added 2013-01-25)

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PD + C + E = reduced oxidative stress

We need oxygen to live. But, too much of a good thing can cause heart and blood vessel damage, and, if you do PD, damage your peritoneum. What can help? Among 20 people doing PD, supplements of the antioxidants vitamins C and E improved measures of oxidative stress, compared to 10 healthy volunteers who did not take the vitamins. (Ask your nephrologist if this is wise for you.)

Read the abstract » | (added 2013-01-25)

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Review: survival on intensive HD vs. transplant

Canadian researcher Robert Pauly reviews the literature on survival with short daily and nocturnal HD, and compares it to kidney transplant survival.

Read the abstract » | (added 2013-01-25)

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PD: Better survival than standard in-center HD

DaVita followed 23,718 patients new to dialysis for 2 years. Those who chose PD (1,358) were nine times more likely to switch treatment options and three times more likely to get a transplant than those who chose standard in-center HD. The PD patients also had 48% better survival than those who did standard in-center HD.

Read the abstract » | (added 2013-01-25)

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Can more fluid removal mean needing less toxin removal?

Makers of a wearable ultrafiltration (UF; water removal) device wanted to know if daily UF could be a way to cut back on the need for dialysis toxin removal. For 4 weeks, 13 in-center patients had 4 days a week of UF plus 2 days a week of HD. Then they did 4 weeks of standard, 3x week HD. Daily UF lowered blood pressure and weight gain between treatments significantly—while Kt/V rose.

Read the abstract » | (added 2013-01-25)

Tags: Chronic kidney disease