Nephrosphere

This is clearly where dialysis is headed. I don’t see them as viable alternatives to a transplant, but certainly sounds better than trucking over to a dialysis unit three times a week. May at least be a legitimate alternative to PD.

Details here.

Dialysis

Association of environmental cadmium exposure with inflammation and malnutrition in maintenance haemodialysis patients — Hsu et al. 24 (4): 1282 — Nephrology Dialysis Transplantation.

The malnutrition-inflammation complex is thought to be one of the contributors to poor outcomes on hemodialysis. Hsu et al, in this NDT paper, tie it to cadmium exposure. An interesting twist on a mysterious problem.

Dialysis

Carrying a pregnancy to term in patients undergoing hemodialysis can be a challenge. Yukari et al. in Kidney International find that lower BUN levels were associated with birth at a greater likelyhood of carrying pregnancy ? 32 weeks and a greater chance of birth weight ? 1.5kg. Although not the focus of the study, it appears that higher hemoglobins also correlated with improved likelihood of delivery.

Dialysis

This study by Lins, et al. published in Nephrology Dialysis Transplanation addresses the age old question of whether continuous renal replacement therapy (CRRT) is superior to hemodialysis (HD) in acute kidney injury. The authors stratified by severity of illness and conclude that there’s no difference between the groups. In my mind, however, the fatal flaw is the people who were left out of the study. Out of the 650 subjects eligible and in need of RRT, over half (n=344) were excluded, 37% of them for clinical reasons (including coagulation distubrances and hemodynamic instability). In other words, the most unstable patietns, the ones most likely to benefit from CRRT, were excluded from the study! It’s hard to conclude much from this other than CRRT probably isn’t advantageous in more stable patients.

Dialysis