Nocturnal HD vs. Transplant: Health-related Quality of Life Compared

In a small study, transplant candidates using nocturnal HD (n=41) and transplant patients (n=31) took the KDQOL-short-form survey of health-related quality of life (HRQOL). Those with transplants had significantly higher “effects” of kidney disease scores than those on nocturnal HD. The other domains were not significant. Read the abstract.

Read the abstract » | (added 2018-10-12)

Tags: Transplant, Nocturnal HD, Kdqol, HRQOL, Effects Of Kidney Disease

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

Left Atrial Remodeling Not Found After 1 Year of Nocturnal HD

While left ventricular mass has been shown to regress with intensive HD, the same does not seem to hold true for the left atrium, nor did the ejection fraction improve, finds a new study of 37 patients switched from conventional HD. Read the abstract.

Read the abstract » | (added 2018-09-10)

Tags: Cardiac MRI, End stage Renal Disease, Hemodialysis, Left Atrium

PD Catheter Outcomes in Low vs. High-Volume Centers

Not surprisingly, patients whose PD catheters were placed at high-volume centers (in Japan) had fewer adverse events, needed feer blood transfusions, and had shorter hospital stays than those from low-volume centers. Read the abstract.

Read the abstract » | (added 2018-09-10)

Tags: PD, Catheter, Hospital volume

5-year study: Predialysis PD Education Saves Lives on PD

Among 398 patients who started PD from 2007-2016, 169 had received predialysis education. After 5 years, this group had a significantly lower rate of peritonitis, a longer median time to a first peritonitis episode, and less risk of death from peritonitis than patients who did not get CKD education. Read the abstract.

Read the abstract » | (added 2018-09-10)

Tags: PD, Predialysis, Peritonitis, Mortality, CKD Education

Gender and Malnutrition in PD

Do hypoalbumineumia, overhydration, inflammation, and cardiovascular risk affect men and women on PD differently? A small study (N=26 men and 28 women) with comparable BMI found more fluid overload, inflammation, and heart risk in women with low serum albumin than in men. Read the abstract.

Read the abstract » | (added 2018-09-10)

Tags: Gender, Malnutrition, Cardiovascular Risk, Hypoalbuminemia, Inflammation, Overhydration, Peritoneal Dialysis

Nocturnal HD is Underused

A new review suggests that the improved outcomes associated with more hours of HD in-center or at home mean that these options should be used more. Read the abstract.

Read the abstract » | (added 2018-09-10)

Tags: Extended Hours, Improved Outcomes, HD, Nocturnal Dialysis, Quality Of Life

Biocompatible PD Solutions Maintain Membranes Longer

Independently of inflammation, biocompatible PD solutions helped 71 patients keep a steady level of solute transport over 7.5 years, compared to 295 patients who used standard solutions. Read the abstract.

Read the abstract » | (added 2018-09-10)

Tags: Dialysis Solutions, Glucans, Glucose, IL6 Protein, Human, Inflammation, Interleukin 6, Peritoneal Fibrosis, Peritoneum, Peritonitis, Creatinine, Hospitalization, Icodextrin, Peritoneal Dialysis, Peritoneal Membrane

Driving Home Dialysis Takes More Than Money

Are financial incentives enough to change nephrologist practice to favor home therapies? Only a little, finds a comprehensive literature review and an international workshop. Other levers, such as the framework of funding for clinics, nephrologist belief in home treatments, and direct costs to patients (e.g., utilities) may play a role as well.

Read the abstract » | (added 2018-08-13)

Tags: Home Dialysis, Financial Incentives, Nephrologist Practice

Home HD After PD Failure May Lead to More Transplants, Lower Mortality

Since PD failure can lead to hospitalization and death in those who switch to standard in-center HD (ICHD), would outcomes improve with home HD? A new analysis found 521 patients in the USRDS data who made the change. Compared to matched ICHD patients, the chance of transplant was nearly double (21% vs. 10.6%), while survival of home HD patients was 89.1% at 1 year and 80.5% at 2 years.

Read the abstract » | (added 2018-08-13)

Tags: PD Technique Failure, ICHD, Transplant, Home HD, Lower Mortality