Journal Watch
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Both UF Rate AND UF Amount Matter
Using data from 152,196 US dialysis patients, researchers looked at what would happen if UF rates were capped at 13mL/h/kg without reducing weight gain or offering longer treatments. On average, 18-36% of patients left treatment > 1 Kg above their prescribed target weights. Without adding time or reducing the gains between treatments, patients may have fluid-related weight gain.
Read the abstract » | (added 2017-06-12)
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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
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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
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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
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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
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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
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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
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Frequent HD in Children
Does 5x/week in-center HD benefit children more than 3x/week treatments? A multicenter pilot followed 8 children with a median age of 16.7 years. Among the 6 patients who completed two study periods, 5 had a sustained 10% or more decrease in systolic BP or antihypertensives during the more frequent treatments. Reimbursement and time burdens are challenges.
Read the abstract » | (added 2017-04-12)
Tags: Hemodialysis
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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
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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