US dialysis education in this study was a FAIL—especially for seniors

In a study of 99 US dialysis consumers, education about options was poor regardless of age—but was far worse in those over age 65. Significantly fewer older people said the doctor explained the cause of their kidney failure, the impact dialysis would have on their daily lives, or the life-long need for dialysis, and most felt that the choice of treatment was made by the doctor.

Read the abstract » | (added 2014-03-07)

Tags: Chronic kidney disease

Colonic dialysis—a 2-year case report

A 20-year old woman has been kept alive for 2 years after refusing dialysis. Instead, she used PD fluid to wash out her bowels (she had bowel surgery that required her to irrigate her bowels so she could move them). Her creatinine has risen from 1.7 mg/dL to 2.8 mg/dL over the 2 years.

Read the abstract » | (added 2014-02-06)

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Nephrologist perspectives on dialysis: An international study

Among 324 practicing nephrologists, 90% had patients using standard in-center HD, 8% had patients on PD, and 2% had some on home HD. Most believed that quality of life was superior on home HD, and that doing more treatments than 3 per week and making them longer would lead to "significantly better clinical outcomes" than than standard treatments.

Read the abstract » | (added 2014-02-06)

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Why it may be best to start with PD first

Those who transfer from HD to PD have higher rates of PD technique failure and death than those who started out on PD. These results come from a new study of more than 13,000 people from Canada. In the first year, the risk of poor outcome was 50% higher among the switchers than in those who started PD in the first place.

Read the abstract » | (added 2014-02-06)

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Diabetes does not worsen PD technique survival

In a registry-based study of 432 patients, the 23% who had diabetes were able to stay on PD just as long as those who did not have the disease. And, more recent PD users had even higher success rates with the treatment than those in past years. However, PD dropout due to loss of autonomy (stroke in particular) and death were higher in the diabetes group.

Read the abstract » | (added 2014-02-06)

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HeRO grafts work as well as regular grafts

The HeRO graft is a last chance for patients who can't have any other type of dialysis access. A new randomized, controlled trial of 72 people (52 with HeRO grafts and 20 with standard arteriovenous grafts) has found similar patency, dialysis adequacy, and infection rates in both types of access.

Read the abstract » | (added 2014-02-06)

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Extended HD improves sleep quality in China, too

Studies find that extended HD helps people sleep better—and, per a new study, this is just as true in China as elsewhere. Forty standard HD patients were switched to in-center nocturnal HD thrice weekly for 6 months. After the switch, Kt/V rose significantly, as did BUN clearance, hemoglobin (with fewer ESAs), and albumin. Phosphorus levels dropped significantly, as did blood pressure. Sleep quality and quality of life were significantly better as well, though sleep quality started to decline again after 2 months.

Read the abstract » | (added 2014-01-08)

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Nocturnal HD may reduce risk factors for sudden heart death

Sudden cardiac death is the leading cause of death on dialysis. A chart review study with ECGs has found that a year of nocturnal HD significantly improved heart function vs. standard in-center HD, even before changes to the left ventricle could be seen. More frequent nocturnal HD decreased Tpeak to Tend and QRS amplitude variation.

Read the abstract » | (added 2014-01-08)

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Fluid overload predicts LVH in people on PD

In a cross-sectional echocardiogram study of 31 people on PD, those with LVH had lower serum albumin levels, higher blood pressure, and more overhydration than those who did not have LVH. Overhydration (p=0.007) was the strongest predictors of LVH in multivariate analysis.

Read the abstract » | (added 2014-01-08)

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How does PD change muscle protein use?

PD is the only form of dialysis that removes protein-bound solutes. But, PD also "induces a new state in muscle protein dynamics," finds a new study, decreasing protein turnover rates and reducing their efficiency. Treatments like use of amino or ketoacids, vitamin D, exercise, and myostatin antagonism for malnourished patients may help.

Read the abstract » | (added 2014-01-08)

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