Home Dialysis News

PHILADELPHIA – Frequent home dialysis therapies may help prolong the lives of patients with kidney failure compared with hemodialysis treatments administered in medical centers, according to a study presented at ASN Kidney Week 2014.

PHILADELPHIA – There has been an assumption that home dialysis therapies offer patients a better quality of life than conventional, in-center therapy. But which home dialysis modality offers the best outcomes?

This blog post originally appeared at Home Dialysis Central's website on Nov. 13. Find more posts from this blog, KidneyViews, at www.homedialysis.org/news-and-research/blog.

Nipro Medical Corporation has launched a new version of its Elisio Polynephron Single Use, High-Flux, Hollow-Fiber Dialyzer. Both the housing and the membrane in the new version are made with material not containing BPA or DEHP. Elisio features a Polynephron membrane similar in function to that of a human kidney, the company said in a release. “We have taken a dialyzer that delivers excellent clearance and reduced thrombogenicity, and improved it by eliminating any BPA or DEHP,” said Joe Dawson, senior vice president of Nipro North America. “Both chemicals are known endocrine disruptors. There are many published studies showing that endocrine disruptors cause adverse effects in animals. As a company that is focused on making products that improve the lives of patients, we are excited that we now have a dialyzer that can do that.” The dialyzer uses pore-spinning technology that creates homogenous pore sizes to optimize sieving properties and improve middle molecule clearance, according to Nipro. In addition, the unique ripple structure in Elisio’s fiber creates less dialysate channeling – promoting better diffusive transport while enhancing small molecule clearances, and reducing the risk of fiber leakage. The new polypropylene housing is also around 25% lighter than current dialyzers in the market, thus making disposal and transportation more cost effective. It also generates 25% less resin waste, and 100?C lower temperature needed to mold polypropylene parts. Polypropylene also generates 10% less CO2 emission for resin production, and 50% less CO2 emission when incinerated, Nipro said in the release. “The eco-friendliness of the Elisio dialyzer is a definite plus,” Dawson said. “In addition, we do not have to compromise on clinical performance, while making a greener dialyzer.”  

In light of the recent peritoneal solution shortage crisis (see our Viewpoint in this issue), it seems prudent to revisit the concept of incremental peritoneal dialysis (PD), in which solution use is efficiently minimized. A working definition of incremental dialysis is adding dialysis in specific doses over time to achieve adequate correction of uremia. This combines the use of residual kidney function (RKF) plus artificial kidney function (i.e. dialysis). While this can be performed with any form of dialysis, this commentary will focus exclusively on incremental PD.

The last 12 months have been quite dramatic for peritoneal dialysis (PD) and its advocates in the United States. In late 2013, the first reliable data on the effect of the new ‘bundled’ prospective payment system for end-stage renal disease on home therapies was published in Peritoneal Dialysis International. 1 This published work confirmed the widespread impression that PD use had dramatically increased since the introduction of the dialysis payment bundle in 2011. Five of the 10 largest dialysis providers in the U.S. reported increases in PD patients, varying from 15–68% between 2009 and 2013. The two largest providers were up 31% and 27%, respectively.

Rockwell Medical Inc. said it has signed an exclusive agreement with Baxter Healthcare Corporation, a subsidiary of Baxter International Inc. (NYSE:BAX), to commercialize Rockwell's hemodialysis concentrate product line in the U.S. and in select overseas markets.

Baxter Healthcare Corporation, in conjunction with U.S. Food and Drug Administration, has initiated temporary importation of Dianeal PD4 Glucose Solutions for Peritoneal Dialysis into the U.S. market to address a shortage, the FDA announced. Baxter will import PD solutions manufactured at the company's Castlebar, Ireland facility. The FDA said it estimates the additional solution will be available beginning in November. 

The risk of hospital admission in home hemodialysis patients was similar to the risk in comparable in-center hemodialysis patients in a recent study published in the American Journal of Kidney Diseases. However, detailed analysis of hospital claims suggested that the similarity had an important caveat: HHD patients were hospitalized less frequently than IHD counterparts for cardiovascular complications, whereas HHD patients were hospitalized more frequently for infectious complications.

Sen. Charles Grassley, R-Iowa, is throwing his weight behind efforts to increase home dialysis training payments for 2015, but the renal community wants it to be “new money” injected into the ESRD Program.