Journal Watch
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And, Again: More HD Improves Quality of Life
Data from the Frequent Hemodialysis Network (FHN) trials found that those who were randomized to frequent or nocturnal HD reported outcomes that included better results on a “feeling thermometer,” better general health, and shorter recovery time than for standard in-center HD.
Read the abstract » | (added 2017-03-09)
Tags: Hemodialysis
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Autonomy is Key to Choice of PD
French researchers interviewed 150 patients who began dialysis between 2010 and 2014 from four clinics, and their nephrologists, to see what factors influence the choice of PD. Of those who could do PD or HD, 46.7% preferred PD. The main reason for this preference was having or wanting to have autonomy.
Read the abstract » | (added 2017-02-08)
Tags: Peritoneal dialysis
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Medicare Payment for Daily Home HD Varies Geographically
According to Medicare claims data for in-center HD and home HD from 2009-2012, there were persistent variations in the home HD treatment claims paid by different Medicare contractors. Fortunately, these differences did not seem to affect whether clinics offered home HD.
Read the abstract » | (added 2017-02-08)
Tags: Hemodialysis
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Heart Disease? PD is a Good Option
In a single clinic study, 112 new patients starting PD with or without heart disease were followed for 5 years. More people with heart disease had diabetes (53.3% vs. 31.7%), and they tended to be older. But, there were no differences between groups in hospital admissions, peritonitis, or PD technique failure.
Read the abstract » | (added 2017-02-08)
Tags: Peritoneal dialysis
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More Hospital Readmissions with PD Than In-Center HD
Those on PD have fewer routine clinic visits than those on standard in-center HD. This may help explain why a 10-year study of hospital discharges among 28,026 dialyzors in Canada found that 30-day readmission rates in PD patients were higher (7.1) than for matched patients doing standard in-center HD (6.0). Better care transitions may help.
Read the abstract » | (added 2017-02-08)
Tags: Hemodialysis, Peritoneal dialysis
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Does Frequent HD Boost Quality of Life? YES
As with nearly every other study, a new paper from the Frequent Hemodialysis Network trial looked at HRQOL among patients randomized to conventional vs. 6x/week HD (N=245) or 6x/week nocturnal vs. conventional home HD (N=87). After one year, patients who dialyzed more often had higher HRQOL than those on standard HD—and shorter recovery after each treatment.
Read the abstract » | (added 2017-02-08)
Tags: Hemodialysis
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Does Frequent HD Boost Quality of Life? NO
A new Canadian study randomized 200 patients to standard in-center HD (12-15 hours/wk; maximum of 18 hours) or extended HD (>24 hours/wk) for a year. Extended HD reduced phosphate and potassium levels and boosted Hgb, and patients took fewer BP meds and phosphate binders. However, health-related quality of life scores did not differ significantly between the groups.
Read the abstract » | (added 2017-02-08)
Tags: Hemodialysis
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A New Approach for Treating Peritonitis in Patients Over Age 50
Researchers tried a new, 3-step “Mero-PerRest” protocol when patients over age 50 developed peritonitis due to enteric (gut) microorganisms. 1). Temporary “peritoneal rest” with the catheter in place. 2). IV meropenem. 3). Meropenum as a catheter lock. Compared to 203 bouts of peritonitis treated with usual care, 217 bouts treated with the new protocol had a higher primary cure rate (90% vs. 65.3%), better PD survival (90% vs. 64.9%), and similar patient survival.
Read the abstract » | (added 2017-02-08)
Tags: Peritoneal dialysis
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Using PET Results to Screen for Encapsulating Peritoneal Sclerosis (EPS)
Identifying EPS early is vital to effectively treat this rare but devastating problem. Researchers studied whether the amount of sodium removed from the dialysate (sodium sieving) could predict EPS, in a 20-year study of 161 people. Age at PD start, duration of PD, and sodium sieving were all important predictors.
Read the abstract » | (added 2017-01-09)
Tags:
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Gender, PD Dose, and Anemia
Do gender and PD adequacy matter in anemia treatment, wondered researchers? Yes, as it turned out. A two-part study first included 2,180 prevalent PD patients, then followed 88 new PD patients for 3 years, recording data once a year. Regardless of adequacy, women had lower hemoglobin levels than men at every point—even with higher ESA doses.
Read the abstract » | (added 2017-01-09)
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