Longer intervals between dialysis not good

We noticed this news item popping up in many news sites, based on a recent research article in the New England Journal of Medicine.

The doctors involved looked at a large number of patients (32,065 to be exact) from the End Stage Renal Disease Clinical Performance Measures Project - a project that gives a representative sample of patients on hemodialysis three times a week. They found that there was an increased risk of heart problems and a low tolerance of metabolic deviations from the normal range.

They suggest that with three day a week dialysis - eg Monday, Wednesday, Friday - the longer gap between the Friday and Monday treatments may be a bit too long. Evidence showed that death rates and hospital admittance rates were higher on the day after the two day gap than at other times. This suggests that the higher level of accumulated toxins at that point in the treatment may be causing these patients problems.

Dialysis patients and their family should perhaps be on the look out for problems and poorer health at the longer gap point in their weekly schedule.

Inverness Dialysis Patient's Canoe Trip

Martin MacRae doesn't think dialysis should tie him to a sick bed, so he has decided to show the freedom gained from his new portable dialysis machine and canoe the breadth of Scotland via the Caledonian Canal. He will be camping at a series of rest points during his six day trip and will have his dialysis each evening for three hours - in his tent!

There are only two of these small units available in Scotland on the NHS, while there are around 70 in England, and thousands in the USA. So Martin is hoping that the sponsorship he has attracted will raise money to purchase more for the renal unit at Raigmore Hospital, Inverness.

Why not support Martin in his venture, by going to Just give to Martin MacRae and donating something, anything.

And wouldn't it be a nice gesture the unit's manufacturers donated a machine... (Hint, HINT, Very Strong Hint)

This was first spotted on the BBC News page on the 30th August, 2011, and an update in the Inverness Courier the next day reported that he successfully completed the first stage. So hurry up and donate!

AWAK testing a portable dialysis unit

The Singapore company Awak Technologies Pte. Ltd. are currently testing a portable peritoneal dialysis unit. There have been many reports of such devices over the last two or three years, but this one looks a bit further along the road than most. The unit has a pump and battery which are connected to a dialysate pack. The video below gives an explanation of the devices (there will be a short advert first however), and you can read more at The Wall Street Journal or at AWAK's own web site.



The spent dialysate is continuously regenerated from the AWAK unit and reused in perpetuity. This is a bit different to normal peritoneal dialysis, where the entire dialysate is replace and the spent solution discarded

It is currently undergoing animal testing in Singapore, in preparation for clinical testing in the U.S., Germany and Singapore.

The company has won an innovation award for their work on this device.

This could be a real bonus for some dialysis patients, giving them much more freedom as they can continuously "top up" on their treatment more conveniently than with standard peritoneal dialysis.

Questions about the safety of Epogen and doses given

Epogen reduces the need for blood transfusions among dialysis patients, and counters the fatigue from long sessions. It's been in production since 1989.

But according to this news report (22 July, 2011), new guidelines have questioned the safety of this and related drugs. According to the report at Vcstar.com, "the FDA finally announced on June 24 new guidelines that are projected to slash the U.S. clinical use of Epogen by as much as a third. The FDA cited the increased risk of cardiovascular events ranging from stroke to death."

Links to the FDA's reports can be read on line and in more detail here (27 June 2011).

The FDA now requires a warning label about risks because of data showing increased risks of cardiovascular events with ESAs. The manufacturers have revised their labelling and on line information about the drug.

Diet that reversed kidney failure in diabetic mice

We missed this report when it came out, but thought it worth including.

A BBC News report covers some research where diabetic mice were fed a diet high in fat and low in carbohydrate. And damage to the kidneys caused by too much sugar was reversed.

The researchers at the Mount Sinai School of Medicine in New York used mice with both type 1 and type 2 diabetes.

Once kidney damage had developed, half the mice were put onto the ketogenic diet for eight weeks.

The highly controlled diet, which is 87% fat, mimics the effect of starvation and should not be used without medical advice. After eight weeks the researchers noted that kidney damage was reversed.

It is also questionable whether the diet used in this model would be sustainable for humans, even in the short term.”

The researchers also need to figure out the exact process that leads to repair.

Dr Iain Frame, director of research at Diabetes UK, said: "This research was carried out in mice so it is difficult to see how these results would translate into any real benefits for people with diabetes at this stage.

As diabetes is a major factor in causing kidney damage and leading to dialysis, IF this could be translated in to something that was usable in humans, it could lead to a major improvement for diabetics.