Journal Watch

  • ESAs save lives and dollars in CKD

    Erythrocyte-stimulating agents like EPOGEN, Procrit, and Aranesp have gotten a bad rap lately. A new study looked back at data from 8,188 patients ages 15 or over with CKD and anemia who were enrolled in health plans. The findings: the 14.6% who received ESAs were less likely to be hospitalized or go to the ER, took longer to reach dialysis, were less likely to die in the hospital—and their care cost less, too.

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

    Tags: Chronic kidney disease

  • TPA reduces HD catheter infections by 50%

    Heparin is put into HD catheters after each use to prevent blood clots. Researchers replaced it with a clot-busting drug used for strokes—TPA—at one treatment per week. The new routine reduced catheter infections. (Hmmm. Is heparin sterile? What if TPA was used at ALL HD treatments?)

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

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  • More people are being told about PD

    In 1997, the DMMS Wave 2 study found that fewer than 25% of people with kidney failure were told about PD. A new survey of people surveyed from 2005–2007 found that 61% were told—though just 10.9% of them chose PD. Still—major progress!

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

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  • It's never too late to educate

    Each year, many people need dialysis within just a few weeks or months of learning that their kidneys have failed. A new Canadian study found that among 228 such people who were educated by a nurse while in the hospital, 49 (21.4%) chose PD, and 22 (9.6%) chose home HD. (In the US, fewer than 8% are home.)

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

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  • Dialysis at a crossroads: 50 years later

    The well-known and highly respected nephrologists who sent a letter to CMS about how to improve dialysis care—with longer and/or more-frequent treatments—have written an article summing up their thoughts.

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

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  • Yet another call for PD first

    Doctors at the University of Missouri have written an article noting that PD is under-used, and suggest ways to promote PD as a first dialysis option. Good idea!

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

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  • Meta-analysis: Icodextrin PD fluid really does have advantages

    In a study of 9 randomized controlled trials, icodextrin removed much more water from the blood of people who did PD than standard glucose-based PD fluid without causing any more health problems for them.

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

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  • Nocturnal in-center treatments save lives

    A new study from Turkey matched 247 people on 8-hour nocturnal in-center HD 3 times a week with 247 doing standard 4-hour HD by age, sex, diabetes, and length of time on dialysis. After a year, those doing nocturnal had 72% better survival—a significant improvement.

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

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  • Watch your water soluble vitamins on nocturnal HD

    More dialysis washes more vitamins out of the blood, finds a new study from Australia. Among people who were doing nocturnal HD, levels of vitamin C and thiamine were low. Supplements may be wise—ask your doctor.

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

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  • Vitamin D deficiency linked with EPO resistance

    What if resistance to EPO is related to low levels of vitamin D that tend to occur in people on dialysis? A new study looks at just that, and found a link. While more rigorous studies are needed, it's an intriguing thought...

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

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