The Impact of ESRD Treatment Modality on Sleep Quality

A metaanalysis looked at whether changing from one treatment type to another (HD, daily HD, nocturnal HD, CAPD, CCPD, or transplant) would affect sleep. Sixteen studies with 670 patients and 191 controls were examined. Restless leg syndrome resolved in 60+% of patients who switched to CCPD, intensive HD, or transplant. Sleep apnea improved with these options as well. Overall sleep quality improved as the intensity of treatment increased.

Read the abstract » | (added 2017-06-12)

Tags: What Is The Best Dialysis Option For Me, Education Issues: For Patients And Professionals

HD frequency and protein-bound solutes

Does more frequent HD do a better job of removing protein-bound solutes from the gut that are more toxic than urea? No, finds a new analysis of results from the Frequent Hemodialysis Network (FHN) trials.

Read the abstract » | (added 2017-05-09)

Tags: Hemodialysis

In-center nocturnal HD boosts lean body mass

Among 56 adults followed for a year, those who were randomly assigned to nocturnal in-center HD vs. standard treatments had higher, more stable interdialytic weights. The pattern of toxin removal suggests that the result is due to increases in lean body mass.

Read the abstract » | (added 2017-05-09)

Tags: Hemodialysis

When to start PD after catheter placement

A new randomized controlled trial included 122 new PD starts at two Queensland, Australia hospitals for 5 years. Participants were randomized to three groups, who started PD at either 1 week, 2 weeks, or 4 weeks after PD catheter placement. Leaks were higher in the 1-week group, while PD technique failure was higher in the 4-week group.

Read the abstract » | (added 2017-05-09)

Tags: Peritoneal dialysis, Catheter

How dialysis clinics can help prevent peritonitis

What can dialysis clinics do to reduce the risk of peritonitis in PD patients? In an analysis of 127 PD clinics and 5,017 new PD patients, having a nurse who specialized in PD or conducting home visits prior to the PD start had the biggest impact.

Read the abstract » | (added 2017-05-09)

Tags: Peritoneal dialysis

Why and how to change the dialysis default to PD

PD is comparable to standard HD in outcomes, but costs less, is more convenient, does a better job of preserving residual kidney function, and delivers better quality of life, argues a new editorial.

Read the abstract » | (added 2017-05-09)

Tags: Peritoneal dialysis

Short daily HD in pediatrics

Dividing 12 hours of in-center HD into 5 weekly treatments instead of 3 was feasible and beneficial to blood pressure control in adolescents in a new crossover study. However, not surprisingly, reimbursement and time demands were challenging. (Editorial note: home treatments would allow more flexibility for school.)

Read the abstract » | (added 2017-05-09)

Tags: Hemodialysis

Ultrafiltration: Speed Kills

Among 190 people on HD, those whose ultrafiltration (fluid removal) rate was higher than the median (just 6.8 mL/Kg/h) were less likely to survive than those who were at or below the median. Most participants did not have residual kidney function.

Read the abstract » | (added 2017-04-12)

Tags: Hemodialysis

In-center Nocturnal HD Beats Standard HD

An analysis of 21 published studies (n=1,165 in-center nocturnal patients and 15,865 standard in-center HD patients) found better BP, higher Hgb, and lower serum phosphate levels in those who dialyzed longer.

Read the abstract » | (added 2017-04-12)

Tags: Hemodialysis

PD vs. Standard HD for People with Cirrhosis

For cirrhotic people with kidney failure, data abstraction from the U.S. Nationwide Inpatient Study between 2005 and 2012 compared outcomes with PD and standard in-center HD. In-hospital mortality for those with ascites was significantly less with PD. In addition, PD hospital stays were shorter and costs were lower. Yet, just 1.7% of the sample was using PD.

Read the abstract » | (added 2017-04-12)

Tags: Peritoneal dialysis, Hemodialysis