Journal Watch
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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)
Tags: Sleep Apnea, CHD, NHD, O2 Saturation, Nocturnal HD, Conventional HD, Sleep Quality
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What Makes Home HD Patients Reach for On-Call Support?
A 4-month prospective observational study analyzed the reasons why 58 home HD patients called the on-call nurse or technician. Most calls to nurses were made for clinical issues or machine set-up or alarm questions, some of which required a technician. Most of the technician calls were for machine malfunction, set-up and alarms, or water treatment. Read the abstract.
Read the abstract » | (added 2018-10-12)
Tags: Home Hemodialysis, Independent Hemodialysis, Nocturnal Hemodialysis, Short Daily Hemodialysis
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Blood Flow Rates and Clinically Meaningful Solute Removal
A prospective study of 17 patients looked at BFRs of 300, 350, and 450 and Kt/V urea, beta-2 microglobulin, and phosphorus when low dialysate flow rates were used. While Kt/V did increase, the impact on B2M and phosphorus were minimal.
Read the abstract » | (added 2018-08-13)
Tags: Daily Hemodialysis, Home Hemodialysis, Kt/V, Blood Flow
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Urgent-start PD in Brazil
In a prospective study, 51 patients who needed dialysis urgently began peritoneal dialysis instead of hemodialysis. Even with high-volume dialysate used less than 72 hours after catheter placement (on alternate days in the dialysis clinic), the option was feasible and safe. Read the abstract.
Read the abstract » | (added 2017-11-13)
Tags: Acute Peritoneal Dialysis, Unplanned Peritoneal Dialysis, Urgent start Dialysis, Urgent start Peritoneal Dialysis
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More CMS Incentives Needed to Boost Home Dialysis
More CMS Incentives Needed to Boost Home Dialysis Have changes in the ESRD Prospective Payment System (“bundle”) designed to increase the use of home dialysis been successful? A new analysis of USRDS data from 2006 to 2013 found that bundling injectable medications and paying for home training did move the needle a bit—but not enough. Compared to patients with other insurance who had a 4.1% increase in home dialysis during this period, Medicare beneficiaries had a non-significant 5.8% rise.
Read the abstract » | (added 2017-10-13)
Tags: Education Issues: For Patients And Professionals, Choosing The Right Path Through ‘The System’
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Waist Circumference Linked to Survival on PD
A prospective study of 109 people on PD measured waist circumference (WC) at baseline and at 6 months, then followed them for 4 years. At baseline, 55% of women had a high WC (>88cm) and 23% of men did (>102cm). After 6 months, The WC of 61% of participants had increased. High baseline WC and an increase were both associated with a higher risk of death.
Read the abstract » | (added 2017-06-12)
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More Inflammation With Standard HD Than With PD
Inflammation can lead to heart damage and poor outcomes. Two 3-month prospective studies with 228 HD and 80 PD patients measured two markers of inflammation: CRP and IL-6. In HD patients, these levels were both higher and more variable than in PD.
Read the abstract » | (added 2016-06-08)
Tags: Hemodialysis
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Using Plant-Protectant Resveratrol to Preserve the Peritoneum
Resveratrol is a phenol found in the skins of grapes and some berries that can help keep blood vessels from growing to support tumors. A new prospective, randomized, controlled, double blind study looked at its use to keep blood vessels from growing in the peritoneum, which can cause PD technique failure. Participants (n=72) were given 12 weeks of low- or high-dose resveratrol or placebo. Those who received a high dose of resveratrol had significantly better ultrafiltration.
Read the abstract » | (added 2016-01-10)
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PD Catheters: To Dress or Not to Dress?
Which is better for preventing exit site infections, a PD catheter dressing, or leaving a healed catheter open to the air? A prospective, randomized, controlled trial in Malaysia followed 108 patients for 2 years. All were instructed to wash the exit site daily with antibacterial soap. The dressing group (n=54) used povidone iodine, mupirocin ointment, sterile gauze, and tape. The non-dressing group did not. Of the 97 patients who completed the study, the results from both groups were similar.
Read the abstract » | (added 2015-10-15)
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Brazil APD Survival Significantly Better than CAPD
A prospective study matched each of the incident APD patients in Brazil with a CAPD patient, using 15 matching factors, and looked at mortality, technique failure, and time to first peritonitis. With 1,445 patients each in the APD and CAPD groups, the researchers found 44% higher mortality among CAPD patients, but no differences in technique failure or time to peritonitis.
Read the abstract » | (added 2015-08-08)
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