Science & medical journals: chronic kidney disease (CKD)
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Straight talk: Improve CKD outcomes by prescribing better dialysis
Longer or more-frequent treatments, better access choices, ultrapure water, and better removal of fluid and toxic middle molecules could improve survival on dialysis, say researchers. Read the abstract.
Better CKD care saves lives
People who met targets for access, hemoglobin, and blood protein levels before starting dialysis were far more likely to survive the first year, finds a new study of 192,307 patients. But just 2% met all three goals—even when they'd been seeing a nephrologist for a year. Read about it.
Give me a D!
No, it's not your grade in math. A new study has found that deficiency of vitamin D (the sunshine vitamin) is present in 79% of people on dialysis—especially if they start treatment in the winter. Too-low levels have been linked to bone and heart disease. Ask your doctor if your levels are where they should be. Read the abstract.
People want treatments that offer FREEDOM
A new study interviewed 52 people who were on one of 4 types of dialysis or had a transplant—and learned that "freedom, convenience, self-care, effectiveness, and simplicity" were important. (We could have told you that.) Read the abstract.
Need high doses of EPO? Might want to check for CMV
A new study from the Netherlands has found that people who have ESRD and have been exposed to the cytomegalovirus (CMV) have immune changes. With fewer working T-cells, they can't respond as well to anemia drugs. Read the abstract.
Need an MRI? Ask for NAC + bicarb
MRI contrast dye can damage kidneys. A new meta-analysis (study of studies) has found that two approaches are better than one in preventing this damage. N-acetylcystein (NAC, or Mucomyst®) plus bicarbonate-based IV fluid reduced the risk of damage by 35%. The authors say this combo treatment should be used for all high-risk patients—including those with CKD. Read the abstract.
CKD education saves lives
A new study from Taiwan found that people who got CKD education were about 3 times less likely to need dialysis during the study period (about a year), and more than 5 times more likely to live than a control group that did not receive the education. Read the abstract.
Slow the rate of CKD with baking soda?
A small UK pilot study found that a group of people with CKD who were randomly assigned to take a tablet of sodium bicarbonate each day had kidney function that fell 2/3 more slowly than controls. The baking soda group was less likely to need dialysis. More research is needed—and a doctor should supervise any medication use in CKD. But this is promising, and more studies may prove the benefit. Read the abstract.
If you have CKD, EAT!
We know that malnutrition in people on dialysis is a killer. Turns out that the same holds true with earlier stages of chronic kidney disease (CKD). A new study found that people with CKD who had lower levels of protein (albumin) in their blood were 70% more likely to die. Read the abstract.
No tested CKD decision aids available
A meta-analysis of 40 studies looks at how people with CKD decide which treatment to choose. The 4 key factors were 1) Personal relationships, 2) Keeping current well-being, normality, and quality of life, 3) Need for control, and 4) Benefits vs. risks. No reliable, tested decision aids are available—yet. Read the abstract.
CKD patients report lack of kidney knowledge
Folks can't choose a home therapy if they don't know it exists. In a new study of 676 people with stage 3-5 chronic kidney disease, most reported having limited or no understanding of their options. The new Conditions for Coverage should help.... Read the abstract.
Why Canadians choose self-care dialysis
A new study randomized 70 new ESRD patients into standard options classes or to have the benefits of self-care taught with a booklet, video, and small group brainstorms. Compared to the group getting standard education, benefits group patients who valued lifestyle were 7 times more likely to choose self-care; those who valued freedom were 9.1 times more likely. Read the abstract.
Phosphorus in colas linked to CKD progression
Soda is already worthless nutritionally—and some types can also raise the risk of chronic kidney disease. A recent study found almost 2 1/2 times the risk of CKD in those who drank 2 or more cola's a day (regular or diet). If you must drink the stuff, looks like it's safest to switch to a non-cola flavor. Read the abstract.
ESAs save lives and dollars in CKD
Erythrocyte-stimulating agents like EPOGEN, Procrit, and Aranesp have gotten a bad rap lately. A new study looked back at data from 8,188 patients ages 15 or over with CKD and anemia who were enrolled in health plans. The findings: the 14.6% who received ESAs were less likely to be hospitalized or go to the ER, took longer to reach dialysis, were less likely to die in the hospital—and their care cost less, too. Read the abstract.