Journal Watch
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A Patient on Home HD for 45 Years
A 62-year old Mississippi woman, one of the first home HD patients of Dr. John D. Bower, is reported to have been on home HD for 45 years now, a record.
Read the abstract » | (added 2019-09-11)
Tags: Home Hemodialysis, Quality Of Life, Long term Survival
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High Fiber Diet May Save Lives on PD
A study of 881 PD patients followed for up to 12 years found that participants who ate more fiber tended to be younger, male, and have more residual kidney function. In those who did not have diabetes, each 1 gram increase in daily fiber intake independently predicted improved survival by 13%.
Read the abstract » | (added 2019-08-14)
Tags: Chronic Kidney Disease, Dietary Fiber, Mortality, Peritoneal Dialysis
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Remote PD Monitoring Reduced Hospitalizations
A study of people starting automated PD matched patients who did and did not receive remote patient monitoring (RPM), with 63 patients in each group. Those who received RPM had significantly fewer hospital stays and days.
Read the abstract » | (added 2019-08-14)
Tags: Automated PD, Remote Patient Monitoring, Hospitalization
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Fluid Management Risks of Incremental HD
Incremental HD critics worry that less-frequent treatments will lead to fluid overload—and they may be right. A sample of 23 patients had interdialytic weight gains (IDWG) analyzed in the first and last 3 months of twice-weekly (2x) HD and first 3 months of thrice-weekly (3x) HD. IDWG exceeded 5.7% of dry weight 0% in the first 3 months of 2x HD—12% in the last 3 months—and 4% after a switch to 3x. The authors said, “fluid management in incident-ESKD patients receiving bi-weekly HD deteriorates prior to conversion to thrice-weekly HD.”
Read the abstract » | (added 2019-08-14)
Tags: Incremental HD, Fluid Management Risks, Volume Management
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Challenges in Assessing Survival of In-center vs. Home HD
It’s treatment time that matters, not location—of course—suggests a new thorough review of the survival data. And, while it is challenging to prove a survival benefit when all home HD is so often conflated (short daily vs. nocturnal, for example), quality of life is demonstrably better—and matters more to patients.
Read the abstract » | (added 2019-08-14)
Tags: Treatment Time, Survival Data, Modality, Quality Of Life
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PD: Better Quality of Life than In-Center HD for 2 Years
Among 989 patients starting PD or in-center HD, health-related quality of life (HRQOL) was measured at 3, 12, and 24 months after dialysis start. PD patients scored higher all along on several key dimensions than HD patients—and this effect lasted up to 2 years. Both PD and HD patients had about the same amount of decline in HRQOL over 2 years.
Read the abstract » | (added 2019-08-14)
Tags: HRQOL, PD, In center HD, Quality Of Life
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Some PD PETs Are Better Than Others
There are three ways to do a peritoneal equilibrium test (PET) to measure how well someone’s peritoneum is able to transport water and wastes. Compared to a traditional PET, a modified PET had good agreement in 21 patients—but the so-called mini-PET did not.
Read the abstract » | (added 2019-08-14)
Tags: Peritoneal Equilibrium Test, PET, Peritoneal Membrane Transport
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Payment Policy is Driving Increases in U.S. Home Dialysis
Follow the money. Analysis of 523,526 patients starting dialysis in the U.S. between 2005 and 2013 found increases in home dialysis use in all groups, and a decline in racial/ethnic differences in home dialysis. However, over time, white patients had an increase in mortality compared to minority patients, while transplant rates remained lower in minority patients.
Read the abstract » | (added 2019-08-14)
Tags: Home Dialysis Outcomes, Racial, Ethnic, Mortality, Transplant Rates
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How longer HD treatments affect bone minerals
The ACTIVE study randomized 200 people to do 24+ hours of HD per week vs. standard (<18 hours per week) HD. Long HD treatments reduced serum phosphate levels, but did not change PTH or serum calcium. In a second analysis of the data, those who did longer HD needed fewer phosphate binders as well.
Read the abstract » | (added 2019-07-15)
Tags: HD Duration, Long Hd Treatment, Serum Phospate, Mineral Metabolism, Phosphate Binders
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Half of PD patients may develop a new glucose disorder
A metaanalysis of nine studies with a total of 13,879 PD patients found that 8% had new-onset diabetes, 15% developed impaired glucose tolerance, and 32% had newly abnormal fasting blood sugar levels. No differences were found by ethnicity. The authors concluded that PD patients should receive glucose tolerance tests.
Read the abstract » | (added 2019-07-15)
Tags: PD, Diabetes, Glucose Tolerance, Blood Sugar Levels, Glucose Tolerance Test