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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More working-age dialyzors who chose PD kept their jobs, found a study of 102,104 people

Each year, half of all new dialyzors are working-age (<65), but most stop work after starting treatment. An analysis of USRDS data from 1992–2003 of people who were working 6 months before dialysis found that those most likely to work were: 1) white men ages 30–49; 2) those with glomerular, cystic, or urologic causes of ESRD; 3) those who chose PD first; 4) those with employer group health plans; 5) those who received ESAs.

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

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CAPD maintains residual kidney function better than APD

A new study followed 505 people on CAPD and 78 on APD for 3 years. The two groups had no major differences in residual kidney function (RKF) at baseline, but those on APD had a much higher risk of RKF loss in the first year. The highest risk of losing all RKF was found in those who had the highest GFRs at the study start.

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

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Oral adsorbents may help reduce levels of uremic toxins

The colon makes some wastes that are removed by the kidneys. So, drugs that keep these wastes from getting into the bloodstream could help keep them from building up in the body when the kidneys fail.

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

Tags: Chronic kidney disease

Simpler pill regimen needed by those using nocturnal home HD

Among 35 people who switched from standard in-center HD to nocturnal home HD, the number of pills per day did not drop—but the regimen was much simplified—and health-related quality of life was significantly improved.

Read the abstract » | (added 2011-03-30)

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Benefits of switching from 3x/week in-center HD to 6x/week home HD

Among 11 people who switched treatments, blood pressure dropped, hemoglobin levels rose (with lower ESA doses), the calcium-phosphorus product dropped (with no change in binder doses), and BMI and serum albumin levels went up. We are so not surprised!

Read the abstract » | (added 2011-03-30)

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AAKP's study of patient satisfaction with kidney education and dialysis (hint: not so good)

977 patients completed a 46-item survey asking about satisfaction with current treatment for kidney failure and education on a scale of 1–10 (with 1 low). Standard in-center HD rated 4.5. PD rated 5.2, home HD was 5.5, and transplant was 6.1. About 31% of participants felt the treatment options were not equally and fairly presented, and 32% had not been educated about home HD.

Read the abstract » | (added 2011-03-30)

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