Frequent dialysis poses risks for kidney disease patients

A soon to be published article in Journal of American Society of Nephrology, reported initial by Science Codex, it is stated that frequent dialysis poses problems for patients, requiring patients to undergo more repair procedures to the site through which blood is removed and returned.

Rita Suri, MD (Western University and Lawson Health Research Institute, in London, Canada) and her colleagues conducted two separate 12-month clinical trials in which they randomly assigned 245 patients to receive either in-center daily hemodialysis (6 days/week) or conventional hemodialysis (3 days/week) and 87 patients to receive either home nocturnal hemodialysis (6 nights/week) or conventional hemodialysis. Three access events were recorded: repair, loss, and access-related hospitalizations.

Among the major findings:

In the Daily Trial, 77 (31%) of 245 patients experienced one of these events, with the daily group having 33 repairs and 15 losses and the conventional group having 17 repairs, 11 losses, and 1 hospitalization.

Overall, the risk for an access event was 76% higher with daily hemodialysis compared with conventional hemodialysis.

Similar trends were seen in the Nocturnal Trial, although the results were not statistically significant.

"Our study is the first randomized trial to show that dialyzing more frequently may have potential harmful effects on the hemodialysis vascular access. This has important implications for patients and physicians considering or performing frequent hemodialysis," said Dr. Suri.

Home-Made Dialysis Machine

I thought I was imagining things when I read this (it is in the UK's Daily Mail for a start, and that usually means unreliable. But here goes anyway.

The article claims that a Chinese man found dialysis at his local center was proving to be just too expensive. So he built his own dialysis machine. Yes, that's what it says. And it goes on to say that he has used it for 13 years so far. Hu, who suffers from kidney disease, made it from kitchen utensils and old medical instruments after he could no long afford hospital fees. He also makes his own dialysis fluid.

Liberally illustrated with images, it shows Hu Songweb connected to his device.

Although a Communist country, China does not have a cradle-to-grave free-at-the-point of use healthcare system.
Instead around half of the population buy basic medical insurance which covers for half the costs of their healthcare. The remainder is paid either by patients or their health insurer. However, this leaves the poorest in China struggling to meet medical bills for serious conditions.

He said two of his friends had died after building and using similar machines - hmmm, not much of a surprize there.

Now perhaps I'm being a bit cautious here, but I would NOT recommend anyone trying this themselves. No, seriously, don't try this.

Kidney tissue grown from stem cells

In what could be breakthrough research for those with damaged kidneys, a group of Japanese scientists at Kyoto University report potential revolutionary results - they have grown human kidney tissue from stem cells.

Stem cells are famous for their ability to grow into any type of human tissue under the right conditions.

The team of pioneers had progressed to the point of formulating intermediate mesoderm tissue from the stem cells, a type of tissue developed midway to fully fledged organ tissue.

A scientist on the project, Kenji Osafune, said that the mesoderm tissue also known as embryonic intermediary could be developed in human beings into ‘specific kidney cells’ or artificially via a test tube.

It should be stressed that this is just the beginning of what could be a long journey to produce artificial kidneys from stem cells, but all such research has to begin somewhere. Indeed this initial work was not aimed at growing an entire kidney.

You can read more in this report and also here The original research was published in Nature Comms

Shares in DaVita being bought

The most famous and successful investor in the world is Warren Buffet, and his company Berkshire Hathaway Inc now owns 15% of DaVita, reported on many financial web sites this week. As more people are given dialysis, obviously his company see this as a good investment.

According to the Davita web site, as of September 30, 2012, DaVita operated or provided administrative services at 1,912 outpatient dialysis centers located in the United States. Plus 24 centers in other countries. Not bad for a company that was founded in 1999. That sort of growth must be what attracted Buffet's company to regularly buy shares in the company.

Controversial Kidney-Dialysis Law Upheld

A law that has been around in Florida since 2002 was challenged in the court, and upheld. Florida doctors will continue to be barred from referring kidney-dialysis patients to labs in which the doctors have financial stakes.

The three-judge panel agreed with a lower court that, among other things, the law did not discriminate against Fresenius and Davita and didn’t violate their constitutional rights.

“Because it is reasonably conceivable that Florida ESRD (end-stage renal disease) patients would be better served if their physicians were prohibited from making self-referrals to associated laboratories, we conclude that the Florida act survives rational basis scrutiny and that the law does not deprive appellants (Fresenius and Davita) of their rights to substantive due process,” part of the ruling said.

It seems to me that if the doctors have to refer patients to a client that doesn't reward the doctor directly, then the doctor must be referring the patient to some other clinic. How does that go against Fresenius and Davita, who challenged the law?

If a doctor who has an interest in a DaVita clinic refers a patient to a Fresenius owned clinic, and vice versa, are they going to give a false report because the patient might end up in the other company's dialysis center? I wouldn't have thought so, it's more of a second opinion from someone who probably will have nothing to gain. So the two companies should stop complaining, IMHO.

You can more read about this here