I Hate Dialysis Message Board

Dialysis Discussion => Dialysis: Home Dialysis - NxStage Users => Topic started by: obsidianom on March 15, 2014, 07:06:54 AM

Title: Short Daily Dialysis Reduces Phosphorus
Post by: obsidianom on March 15, 2014, 07:06:54 AM
Another good news article for Nxstage short daily dialysis ,. For those with phosphorus issues(most dialysis patients) , Nxstage is a great help.

Journal Watch

Short daily HD may reduce phosphate burden vs. standard HD
 

In a small study of short daily HD users (n=24) vs. standard in-center HD users (n=54), serum calcium, serum phosphorus, and PTH levels were similar between the two groups. But, levels of fibroblast growth factor 23—which may be a marker of cumulative phosphate burden in the body—were significantly lower with short daily HD (P<0.01).

 
Read the abstract » | (added 03/07/2014)

My wife has very low phosphorus since going on Nxstage. No binders at all. In fact we have to sometimes ADD phosphorus.

Title: Re: Short Daily Dialysis Reduces Phosphorus
Post by: Hemodoc on April 08, 2014, 02:42:10 PM
Not always the case. With NxStage especially at the lower dosages first prescribed did not lower PO4 levels, just the opposite.

http://www.ncbi.nlm.nih.gov/pubmed/17403175

I would like to see other studies on this issue, but the serum PO4 in this study did not decrease as we have seen clearly in many nocturnal studies for instance. PO4 is cleared by TIME on machine. It is not as volume dependent as other factors.
Title: Re: Short Daily Dialysis Reduces Phosphorus
Post by: Speedy1wrc on April 08, 2014, 09:03:25 PM
In my case the opposite as well. In center I actually had normal to low phosphorus. On home hemo I actually am struggling to keep it below high. I watch my diet much more carefully with respect to phosphorus on home hemo than I did in center, and it's always borderline high. I have also had to increase my binders to keep it in check.
Title: Re: Short Daily Dialysis Reduces Phosphorus
Post by: Hemodoc on April 08, 2014, 11:37:24 PM
In my case the opposite as well. In center I actually had normal to low phosphorus. On home hemo I actually am struggling to keep it below high. I watch my diet much more carefully with respect to phosphorus on home hemo than I did in center, and it's always borderline high. I have also had to increase my binders to keep it in check.

You will need to discuss increasing your NxStage volume, frequency perhaps and TIME on the machine. Many doing 8 hour treatments with 20 L found their PO4 dropping too low. TIME is the most important factor when looking at middle molecules and PO4 but by far, this is not the only factor.