NxStage and 2008K@Home Head-to-Head

Compared to NxStage users, those who dialyzed on a 2008K@Home did fewer treatments per week but had significantly higher standardized weekly Kt/V’s. NxStage users tended to use less ESA medication. No differences were found in other parameters, including levels of albumin, calcium, phosphorus, PTH, or in hospital stays.

Read the abstract » | (added 2016-01-10)

Tags: Hemodialysis

Cost Effectiveness: Conventional vs. High Dose HD

An analysis of seven studies of high dose HD found that it is cost effective when delivered at home.

Read the abstract » | (added 2016-01-10)

Tags: Hemodialysis

Why Do People Stop Doing Home HD?

Among 2,840 people who started home HD between 2007 and 2009, nearly one in four stopped within a year, while 1-year mortality was 7.6%. The risks of stopping home HD were higher among those with diabetes, and substance use (alcohol, tobacco, drugs). Those who were listed for transplant or lived in rural areas were less likely to stop home HD.

Read the abstract » | (added 2016-01-10)

Tags: Hemodialysis

PD After Loss of Residual Kidney Failure

Once residual kidney function is gone, it is vital to address fluid volume, finds a new study that followed 183 people. During the 10.5-36 months of follow up, 65% either switched to HD or died. Their inflammation rates (measured by C-reactive protein levels) were high, as were their extracellular water levels (measured by bioelectrical impedance analysis).

Read the abstract » | (added 2016-01-10)

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Gentamycin Ointment For PD Exit Sites Did Not Increase Antibiotic Resistance

A review compared 10 years PD exit-site care using oral rifampin and mupirocin ointment (n=265) with 10 years of gentamycin cream (n=179). While the demographics were largely similar apart from race, there were significantly fewer gram-negative exit site infections using gentamycin, with very low rates of gentamycin resistant infections in either period.

Read the abstract » | (added 2015-12-10)

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Buttonhole Cannulation Does NOT Raise Infection Risk—at Satellite

AVF infection rates were examined among 162 patients from 1990 through 2012, which represents a changeover from rope ladder cannulation (1990-1998) to the Buttonhole technique (1998 onward). The difference in infection rates between the two techniques was not significant. Recurrence of AVF-infection was found only during time 2.

Read the abstract » | (added 2015-12-10)

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Home HD Has Shorter Recovery Time After Treatment Than In-Center HD

A UK study asked 288 people “how long does it take for you to recover from an HD session?” Compared to a mean of 193 minutes (3+ hours) for the 197 people dialyzing in-center, the 91 home dialyzors had a mean of 67.3 minutes (just over an hour). While conventional home HD vs. intensive home HD had similar results, those who made more urine recovered faster.

Read the abstract » | (added 2015-12-10)

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Meta-Analysis: Longer Dialysis, Better Pregnancy Outcomes

A new metaanlysis analyzed 190 papers and 25 abstracts covering 681 pregnancies in 647 women on dialysis. Meta-regression analysis found that more hours of HD per week was associated with a lower rate of preterm delivery, and that more dialysis sessions per week was associated with larger birthweight babies. Case reports suggested fewer small for gestational age babies with HD than with PD. No increased risk of birth defects was found.

Read the abstract » | (added 2015-12-10)

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RCT of Self-Locating PD Catheter Finds Fewer Flow Problems

Coiled or straight, Tenckhoff catheters often clog. A new small trial randomized 61 people to receive a straight Tenckhoff (n=32) or a new, self-locating Wolfram PD catheter (n=29) for urgent start PD. Seven of the Tenckhoff’s had to be swapped for Wolframs due to flow issues—but the reverse was not true.

Read the abstract » | (added 2015-12-10)

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Liraglutide Has Multiple Benefits in People with Diabetes on PD

In a small study, injectable liraglutide was tested in 16 people with type 2 diabetes who use PD, 11 of whom were previously on insulin, while three used oral medications and two controlled their blood sugar using diet alone. After 12 months, glucose fluctuations were reduced, post-meal blood sugars were lower, systolic blood pressure dropped—and left ventricular mass decreased (on echocardiogram).

Read the abstract » | (added 2015-12-10)

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