Short daily HD reduces left ventricular mass

The Frequent Hemodialysis Network trials found significant reductions in left ventricular mass (LVM)—with greater benefit for patients whose left ventricular mass was higher than normal at the start of the study.

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Nocturnal in-center HD survival about 50% better than standard in-center HD

A Fresenius study followed 946 patients doing 3x/week nocturnal in-center HD with 2,062 matched patients doing standard in-center treatments. After 2 years, 27% of those doing standard treatments had died, vs. 19% of those who did the longer, nocturnal treatments.

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Mupirocin best for preventing PD exit site infections

A new double blind, controlled study of mupirocin antibiotic ointment vs. polysporin found that mupirocin came out on top. Twice as many patients who used polysporin had exit site redness and they were more likely to get fungal infections.

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How to do urgent-start PD

Researchers developed an urgent-start PD plan to address the needs of people who needed dialysis right away and had not chosen a treatment option. The outcomes of urgent-start PD patients were very similar to those of regular-start patients, though the urgent-start group had more minor leaks.

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Short daily HD survival 13% better than than standard in-center HD

When 1,873 short daily home HD patients were matched with 9,365 standard in-center HD patients, those who did more frequent HD had a better chance of living longer.

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Thrice-weekly nocturnal HD reduces arterial stiffness

A Turkish study compared 60 people on standard in-center HD to 60 on nocturnal in-center HD. After a year, those who did nocturnal HD needed fewer blood pressure meds, had lower serum calcium and calcium-phosphorus product, reduced left ventricular mass, and their arteries were less stiff.

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Buttonhole needle technique causes less bleeding, pain

A small study in Thailand (21 patients') has found that stopping bleeding after removing dialysis needles takes less than half as long with the Buttonhole technique (4.19 +/- 1.66 mins) than with the rope ladder technique (9.12 +/- 2.36 mins), and causes significantly less pain.

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Metaanalysis: Later dialysis start is better for HD

Starting dialysis at a lower GFR allows more time for access placement and options education. But the U.S. trend has been to start earlier. A new metaanalysis of 17 studies found that starting dialysis at a higher GFR was linked with a significantly higher risk of all-cause mortality—in HD, but not PD. The mortality risk was lower when GFR was calculated than when it was estimated.

Read the abstract » | (added 2012-08-16)

Tags: Chronic kidney disease

Metaanalysis: More HD boosts heart health

A metaanalysis of 46 studies concluded that switching from standard in-center HD to longer and/or more frequent HD significantly reduced left ventricular mass and improved blood pressure and the cardiac ejection fraction.

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Intensive HD survival 50% better than standard in-center HD

A new study comparing 420 patients in the International Quotidian Dialysis Registry with 338 matched standard in-center HD patients from the DOPPS study found that only 13% of patients who did at least 5.5 hours of HD at least three times a week died—vs. 21% who did standard treatments.

Read the abstract » | (added 2012-08-16)

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