U.S. barriers to home dialysis treatments

Home dialysis is underused in the U.S., and a committee of the International Society for Peritoneal Dialysis has looked at why that may be. The group organized the barriers into three groups: educational, government/regulatory, and dialysis practice, and is looking at strategies to address each.

Read the abstract » | (added 2011-09-29)

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A new look at dialysis treatment length

There is increasing proof that dialysis treatments shorter than 4 hours are not long enough. A new paper reviews the literature knowing what we know now—and concludes that most people should get at least 4 hours per treatment.

Read the abstract » | (added 2011-09-29)

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Patients educated about options are more likely to choose home

A new UK study surveyed 118 people with CKD who were not yet on dialysis. Those who were educated about their options were much more likely to plan for home treatment. The most important factor in their choice: fit of a treatment option with the preferred lifestyle.

Read the abstract » | (added 2011-09-29)

Tags: Chronic kidney disease

Standard PD fluids work just as well as biocompatible ones

A randomized controlled trial compared standard PD fluid to biocompatible PD fluid in 267 patients (for 7000+ dialysis months). There were no differences in PD technique survival or peritonitis between the groups.

Read the abstract » | (added 2011-08-25)

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Tweaking the PD cycler prescription can have big payoffs

Changing dwell time make a difference in how well PD works, finds a new, randomized crossover study of 19 patients. All received the same number of hours of PD using the same PD fluid prescription. But instead of doing several exchanges each with the same dwell time and volume, the researchers first used a short dwell time with a small fill volume to remove water, then a longer dwell time and larger volume to remove wastes. The change significantly improved urea, creatinine, phosphorus, water removal, and mean blood pressure. (To learn more about how to adjust a PD prescription, read our Life@Home article on the topic by Joanne Bargman: Tailoring automated PD to your life.)

Read the abstract » | (added 2011-08-25)

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Home HD and mortality risk in Australia and New Zealand

Researchers analyzed data from 26,016 patients in the ANZDATA registry (856,007 patient-months) to see if home HD helped people live longer. Compared to standard in-center HD, those on standard (3x/week), more-frequent, or nocturnal home HD were about twice as likely to survive.

Read the abstract » | (added 2011-08-25)

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Changing the treatment options paradigm: Home vs. in-center, not PD vs. HD

Traditional ESRD treatment options education divides the choice into PD vs. HD, and then looks at home HD. Drs. Thodis and Oreopoulos suggest that it makes more sense to look at home (PD and HD) vs. in-center instead.

Read the abstract » | (added 2011-07-26)

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The frontier of regenerative medicine—what it can mean for kidney disease

While dialysis can remove wastes and excess water from the blood, it can't replace or respond to hormones like healthy kidneys do. Regenerative medicine is at the cutting edge of efforts to grow kidney cells in the lab—with the goal of one day growing new kidneys. And, that day may not be far off.

Read the abstract » | (added 2011-07-26)

Tags: Chronic kidney disease

Choosing PD may mean fewer access procedures for you

In a study of 369 Canadians with ESRD, 224 (61%!) chose PD, and just 145 (39%) chose HD. After an average of 1.3 years, those who chose PD had significantly fewer access procedures. PD catheters were less likely to fail than HD access.

Read the abstract » | (added 2011-07-26)

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Ratios of Omega-6 to Omega-3 fats may impact health in kidney disease

Western diets tend to have too much omega 6 and not enough omega 3 fatty acids. In 145 people on standard in-center HD, having too much omega 6 was linked with significantly higher inflammation.

Read the abstract » | (added 2011-07-26)

Tags: Chronic kidney disease