Starting with PD Better than Switching to it from HD
A metaanalysis comparing patients who started with PD to those who began HD and then switched to PD after 3 months found significantly better overall and technique survival in the PD first group. There were no significant differences in the peritonitis rate.
Read the abstract » | (added 2020-07-10)
Metaanalysis of Nocturnal HD and Sleep Quality
Nine studies of 286 patients found significantly less sleep apnea and better O2 saturation—but less total sleep time—after switching from conventional to nocturnal HD. Prospective pre-post studies found improved sleep quality, but randomized trials did not. Read the abstract.
Read the abstract » | (added 2018-10-12)
If One PD Exit Site Antibiotic is Good, Are Two Better?
In a single center study, 146 people on PD were randomized to use gentamycin cream on their exit sites (n=71) or to switch between gentamycin in odd months and mupirocin in even months (n=75). After 174 (gentamycin) or 181 patient years (alternating), the group switching between two antibiotics had significantly more peritonitis, especially gram-negative and fungal.
Read the abstract » | (added 2016-04-12)
Less Severe Itching With PD Than In-center HD
Among 380 people on PD or in-center HD, fewer on PD had uremic pruritus (itching) (28.6% vs. 38.2%). And, the itching was less severe in those who did PD, and affected less of the body. Those with higher levels of active vitamin D had less intense itching. Those with higher blood levels of phosphorus, triglycerides, and AST had more itching problems.
Read the abstract » | (added 2016-03-10)
Case Report: Thrombocytopenia with NxStage
Two patients have developed thrombocytopenia while using NxStage dialysis machines, perhaps due to electron-beam sterilization of the dialyzers. Switching to another machine resolved the problem; but it recurred in the patient who retried NxStage.
Read the abstract » | (added 2015-11-11)
Nocturnal in-center HD comes to Slovenia
Only a few handfuls of US clinics offer nocturnal in-center HD. Now, Slovenian researchers report their experience of switching 10 patients from "standard" (4-5 hours!) in-center treatments to thrice weekly 8-hour long nighttime ones. With almost twice as much dialysis per week, mean predialysis creatinine and urea dropped significantly, as did mean dry weight. Six of the ten were able to stop taking phosphate binders, and one more patient had a dose reduction—and phosphate was added to the dialysate for three patients. There were no major changes in predialysis blood pressure, calcium or potassium levels, mean ultrafiltration, hemoglobin, or EPO dose (Editor's note: perhaps because standard HD in Slovenia is longer, and because the nocturnal treatments were only three times per week).
Read the abstract » | (added 2013-10-02)
Itching? It May Be Due To High Calcium—Not Phosphorus
A study of 120 HD patients found high levels of serum phosphorus and parathyroid hormone (PTH) in those with and without dialysis itching (pruritus). But, the itchiest patients had significantly higher serum calcium levels.
Read the abstract » | (added 2013-07-17)
If at first you don't succeed with PD...it still costs less than in-center HD
A 4-year Canadian study has found that over a 3-year period, the cost of starting on PD and then switching to HD ($114,503) is still much less than doing standard in-center HD ($175,996). But starting and continuing PD is the lowest cost dialysis option ($58,724).
Read the abstract » | (added 2013-01-25)
Metaanalysis: More HD boosts heart health
A metaanalysis of 46 studies concluded that switching from standard in-center HD to longer and/or more frequent HD significantly reduced left ventricular mass and improved blood pressure and the cardiac ejection fraction.
Read the abstract » | (added 2012-08-16)
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)