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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Lying down during dialysis beats sitting up, new study suggests

When we lie down, our blood plasma volume expands, and when we sit up, it contracts. A new study concludes that nocturnal dialysis causes smaller day-to-day shifts in hemoglobin and serum albumin (protein) than standard, seated treatments.

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

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More dialysis, longer life

In 2003, researchers from the 12-nation Dialysis Outcomes and Practice Patterns (DOPPS) study found that HD treatments shorter than 3.5 hours had a 33% higher risk of death. A new DOPPS paper reports that each extra 30 minutes of HD reduces the relative risk of death by 7%. Unfortunately, this study also documented mean US in-center treatment times of...3.5 hours.

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

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Depressed and on PD? Sertraline (Zoloft) may help

Of 32 people on PD who had clinical depression, 25 agreed to try Zoloft. Twelve weeks later, the Zoloft group was less depressed and had better physical and mental function, with no adverse drug effects.

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

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Soy reduces heart disease risk on PD

Adding 1/2 oz. of soy protein per day for 8 weeks reduced the levels of Lp(a)—a marker of risk for heart disease—in people on PD. In the study, 20 people were randomly assigned to get the soy protein, while 20 did not.

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

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PD and home HD don't compete with each other

A new study finds that different people are attracted to PD vs. home HD. Those who chose PD tended to be older, female, and have diabetes and/or high blood pressure. Those who chose home HD were younger, more likely to be male, and had heart or blood vessel disease. Both treatment options are growing worldwide (perhaps because they're better?!).

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

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PD: Better survival than standard HD for up to 5 years

In a study of 9,277 people, DaVita researchers have found a 40% improvement in 5-year survival vs. standard HD in people aged 60 and under, and 35% in those older than 60. It's becoming clear that ANY treatment option is better for survival and quality of life than standard HD!

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

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Older patients had better quality of life, fewer burdens, on PD

Among 140 people aged 65 or older, those using PD had fewer symptoms and felt that PD intruded less into their lives than those on HD. People on PD had better quality of life, too.

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

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Fresenius publishes home study of 2008K machine

A newly-released study follows 29 stable HD patients in-center for 6 months and then at home for 6 months on 2008H or K machines. While in-center, patients had 5.84 adverse events per 100 treatments—which dropped to just 3.34 events per 100 treatments at home.

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

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Dialysate regeneration for home HD

Dr. Ronco's been busy: he is also a co-author on an article this month about a system to use two activated carbon columns to regenerate dialysate.

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

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