Journal Watch

  • Redefining HD adequacy based on phosphorus

    High phosphorus levels in dialyzors cause a host of life-threatening problems—but a higher HD dose based on urea clearance doesn't save lives. An article in Seminars in Dialysis suggests that we use phosphorus removal as a marker instead. Daily and nocturnal HD both remove more phosphorus than standard HD. It's time to give another marker a try.

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

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  • New study finds better survival with short daily home hemo

    Compared to USRDS survival figures for conventional (3 times a week) in-center hemo, 117 people using short daily home hemo had a significantly lower standardized mortality rate, found a study by Drs. Blagg, Kjellstrand, Ting, and Young.

    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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  • 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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  • Take your vitamins

    A new study finds that HD—with regular or high flux membranes—removes large amounts of water soluble vitamins.

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

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  • Need a bone density test on PD? Be sure you're empty

    A new study has found that having fluid in your belly when you have a bone density test (called DXA) can change the results.

    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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  • 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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  • 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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  • 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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