Journal Watch

  • Australian nephrologists say PD first, then nocturnal HD

    A lengthy survey of Australian nephrologists found strong agreement that long HD is a good option—most easily done at home, and that PD is a great first choice for dialysis. In fact, 34% of respondents said their clinic had a "PD First" policy.

    Read the abstract » | (added 2011-05-23)

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  • New model using routine lab tests can predict progression to kidney failure

    Researchers looked at data from a total of 8,391 people with stages 3–5 CKD to see if lab test results could predict who would progress to end-stage. A model that included age, sex, GFR, and protein in the urine worked best.

    Read the abstract » | (added 2011-05-23)

    Tags: Chronic kidney disease

  • CKD education rates in Australia (they're FAR better than in the US!)

    It's hard to choose a treatment option for kidney failure that fits your life when you don't know what the options are, or how they might affect you. A study of 721 people new to dialysis in Australia found that 603 (84%) had options education before they started treatment.

    Read the abstract » | (added 2011-05-23)

    Tags: Chronic kidney disease

  • Better PD technique survival in people with diabetes who use icodextrin

    In the first randomized control trial using icodextrin in lieu of glucose for PD solution, 41 people with diabetic nephropathy were assigned one or the other. After 2 years, 71.4% of the icodextrin group was still doing PD, while only 45% who used glucose-based solution still did PD.

    Read the abstract » | (added 2011-04-25)

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  • 87 people on nocturnal home HD for 12 years had just 30% the mortality of standard HD

    How does survival of people on nightly home HD compare to those in the USRDS? A single-center study of 87 people who got 40±6 hours a week of HD found that 79% lived 5 years, and 64% lived for 10 years—a mortality rate just 30% of the USRDS average. Higher levels of education and more hours of dialysis were the only factors independently linked with survival.

    Read the abstract » | (added 2011-04-25)

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  • Chemical ablation to correct recurrent secondary hyperparathyroidism post parathyroidectomy

    Reoperation after a parathyroidectmy can be risky. In a study of 49 people, injecting ethanol (alcohol) into the gland, guided by ultrasound, helped to lower PTH levels without more surgery.

    Read the abstract » | (added 2011-04-25)

    Tags: Chronic kidney disease

  • Fleet enemas can safely be added to nocturnal HD dialysate to boost phosporus levels

    Nocturnal HD removes so much phosphorus that dialyzers may need supplements. Fleet® enemas are a low-cost, easy-to-obtain source of phosphorus. The amount of added phosphorus was predictable, and the product did not add bacteria or endotoxin to the dialysate.

    Read the abstract » | (added 2011-04-25)

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  • Nocturnal HD makes pill regimens simpler but doesn't require less pill use

    A study of 35 people on nocturnal home HD looked at how complex their pill regimens were, and how many pills they needed each day. After 2 years, they still needed just as many pills—but the regimen was much simpler. Dialyzors needed fewer BP pills and binders, but more vitamins and antibiotics.

    Read the abstract » | (added 2011-04-25)

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  • Long, slow HD removes more small & middle molecules than standard HD

    A study that processed the same total blood and dialysate volume on two different time schedules looked at the importance of treatment time. Eleven people had a 4-hour and an 8-hour HD session, at least one week apart. Significantly more small and middle molecules were removed in the 8-hour treatments, though protein-bound solutes were not affected.

    Read the abstract » | (added 2011-04-25)

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  • Switching from 3x4 hours HD to 6x3 hours reduced blood pressure, and improved hgb, albumin, & BMI

    Healthy kidneys work 168 hours a week, but most people only get about 12 hours of dialysis. In this study, 11 people were switched to more frequent HD. After 12 months, they had significantly better blood pressure with fewer meds, higher hgb levels with lower ESA doses, higher albumin levels, lower dry weight, and better BMIs. Calcium-phosphorus products dropped significantly with no changes in binder doses.

    Read the abstract » | (added 2011-04-25)

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