Journal Watch
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Long-term effects of daily HD on vascular access
Does more frequent use of a vascular access create problems for those who do short daily HD? A new 4-year prospective, randomized study of 77 people says NO. Patients did six 3-hour HD sessions per week (n=26) or three 4-hour sessions (n=51). There were fewer access procedures in the daily group (543.2 per 1000 patient years, vs. 400.8), though this difference was not significant. There was also no difference in time to first access revision or access failure.
Read the abstract » | (added 2012-10-25)
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Longer or more-frequent HD normalizes mortality patterns
It has long been known that those on PD have an equal chance of dying on any day of the week—while standard in-center HD are much more likely to die on a Monday (or Tuesday with Tue-Thu-Sat treatments). A new study looking at 14,636 Australian registry deaths found that those who got more than 3 standard in-center treatments per week or did home HD were no more likely to die on a Monday (or Tuesday) than any other day.
Read the abstract » | (added 2012-09-25)
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Are infections requiring hospitalization more common with PD or standard HD?
A study in Canada paired 910 people on PD with people on HD, matched by age, race, smoking, BMI, comorbid conditions, and lab data. After 2 years, researchers found that those on PD were more likely to be in the hospital for peritonitis—but less likely to have sepsis or pneumonia than those on standard HD.
Read the abstract » | (added 2012-09-25)
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A "self-locating" PD catheter
The Di Paolo self-locating PD catheter was tested in 20 patients in Italy. The researchers found no infections, and only 0.8% dislocated catheters—vs. 12% for Tenkhoff PD catheters.
Read the abstract » | (added 2012-09-25)
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Reasons why patients prefer more HD
An in-depth, interview study of 10 short daily or nocturnal HD patients in Canada found four main reasons why they liked their choice. 1) They felt better physically and mentally. 2) They felt more in control of their time. 3) They didn't feel "sick" and were more able to work. 4) They had the support they needed to succeed.
Read the abstract » | (added 2012-09-25)
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Thrice-weekly nocturnal HD reduces arterial stiffness
A Turkish study compared 60 people on standard in-center HD to 60 on nocturnal in-center HD. After a year, those who did nocturnal HD needed fewer blood pressure meds, had lower serum calcium and calcium-phosphorus product, reduced left ventricular mass, and their arteries were less stiff.
Read the abstract » | (added 2012-08-16)
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PD in older patients
This study from Ireland looked at 148 people over age 50 who started PD between 1998 and 2008. The mean age was 63; most were over 70. The researchers found no difference in survival or technique survival by age, though older people did need a longer hospital stay to get started on PD.
Read the abstract » | (added 2012-08-16)
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Nocturnal in-center HD survival about 50% better than standard in-center HD
A Fresenius study followed 946 patients doing 3x/week nocturnal in-center HD with 2,062 matched patients doing standard in-center treatments. After 2 years, 27% of those doing standard treatments had died, vs. 19% of those who did the longer, nocturnal treatments.
Read the abstract » | (added 2012-08-16)
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Intensive HD survival 50% better than standard in-center HD
A new study comparing 420 patients in the International Quotidian Dialysis Registry with 338 matched standard in-center HD patients from the DOPPS study found that only 13% of patients who did at least 5.5 hours of HD at least three times a week died—vs. 21% who did standard treatments.
Read the abstract » | (added 2012-08-16)
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Metaanalysis: More HD boosts heart health
A metaanalysis of 46 studies concluded that switching from standard in-center HD to longer and/or more frequent HD significantly reduced left ventricular mass and improved blood pressure and the cardiac ejection fraction.
Read the abstract » | (added 2012-08-16)
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