Telehealth: Acceptability, clinical interventions and quality of life in peritoneal dialysis.

Introduction: Telehealth technologies are being widely adopted across the globe for management of long-term conditions. There are limited data on its use, effectiveness and patient experience in end-stage renal disease. The aim of this pilot project was to explore patient acceptability of technology and evaluate its effect on clinical interventions and quality of life in patients undergoing peritoneal dialysis.

Symptomatic fracture risk in the renal replacement therapy population.

Background: Bone fractures are an important cause of morbidity and mortality in patients on renal replacement therapy (RRT). The aim of this multicentre observational study was to quantify the incidence of radiologically proven bone fracture by anatomical site in prevalent RRT groups and study its relationship to potential risk factors.

Methods: We performed a retrospective analysis of electronic records of all 2096 adults prevalent on RRT in the West of Scotland on 7 July 2010 across all hospitals (except one where inception was 1 August 2011) to identify all subsequent radiologically proven fractures during a median 3-year follow-up.

Thrice-Weekly Nocturnal In-Centre Haemodiafiltration: A 2-Year Experience.

Background: Adequate control of plasma phosphate without phosphate binders is difficult to achieve on a thrice-weekly haemodialysis schedule. The use of quotidian nocturnal dialysis is effective but not practical in the in-centre setting. This quality improvement project was set up as an exercise allowing the evaluation of small-solute clearance by combining convection with extended-hour dialysis in a thrice-weekly hospital setting.

Effect of high haematocrit on the efficiency of high-flux dialysis therapies.

Background: There is a concern that high haematocrit (Hct) levels will reduce the efficiency of dialysis treatments, particularly in post-dilution haemodiafiltration (HDF) where there is the potential for intense haemoconcentration within the dialyser.

Methods: We measured serial Hct and performed serial clearance measurements for urea, phosphate, beta(2)-microglobulin and myoglobin in 12 patients with Hct >35% on high-flux haemodialysis (HFHD) or HDF. We assessed whether changes in the intra-dialyser Hct influenced solute clearance and whether there were differences between the two modalities.

Kt/V underestimates the hemodialysis dose in women and small men.

Current guidelines suggest a minimum Kt/V of 1.2 for three weekly hemodialysis sessions; however, using V as a normalizing factor has been questioned. Parameters such as weight(0.

Phosphate kinetics during hemodialysis: Evidence for biphasic regulation.

Background: Hyperphosphatemia in the hemodialysis population is ubiquitous, but phosphate kinetics during hemodialysis is poorly understood.

Methods: Twenty-nine hemodialysis patients each received one long and one short dialysis, equivalent in terms of urea clearance. Phosphate concentrations were measured during each treatment and for one hour thereafter.