LAWRENCE, Mass.—NxStage Medical, Inc., today announced the latest interim findings from its FREEDOM (Following Rehabilitation, Economics and Everyday-Dialysis Outcome Measurements) Study, which found daily home hemodialysis (HHD) treatments with the NxStage System One are associated with long-term improvements in various physical and mental quality of life measures.

These interim FREEDOM Study results, "At-Home Short Daily Hemodialysis Improves the Long-Term Health-Related Quality of Life," were published online on Kidney International's website in advance of its release in print.

NxStage's FREEDOM Study is the largest prospective study of frequent HHD to date. The FREEDOM Study reported improvements in several quality of life measures in end stage renal disease (ESRD) patients at 12 months of follow-up, including:

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10% to 20% of dialysis patients receive peritoneal dialysis.

Newswise — Washington, DC (May 24, 2012) — An infection called peritonitis commonly arises in the weeks before many dialysis patients die, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). The findings suggest that peritonitis may be a deadly condition for some kidney failure patients.

Most kidney failure patients on dialysis get their treatments at a clinic, through hemodialysis. But about 10% to 20% receive treatments at home through peritoneal dialysis, where fluids are first pumped into the abdominal cavity to collect wastes from the blood and are later removed from the body. Unfortunately this fluid can become infected, causing a condition called peritonitis. This occurs as commonly as twice a year to once every five or six years.

Neil Boudville (University of Western Australia, in Perth) and his colleagues evaluated whether peritonitis affects the survival of patients on peritoneal dialysis. They looked at information from all kidney failure patients (1,316 individuals) who received dialysis in Australia and New Zealand from May 2004 through December 2009 and who died while undergoing treatment or soon after.

Compared with the rest of the year, patients were more likely to develop peritonitis during the 120 days prior to their death, and even more so during the final month before their death. Specifically, they were six times as likely to develop peritonitis during the 30 days prior to their death compared with six months earlier.

“We have therefore proposed a potential new definition for a cause of death—“peritonitis-associated death”—being any death within 30 days of an episode of peritonitis,” said Prof Boudville.

Study co-authors include Anna Kemp, PhD, Philip Clayton, Wai Lim, PhD, Sunil Badve, Carmel Hawley, Stephen McDonald PhD, Kathryn Wiggins, MD, Kym Bannister, MD, Fiona Brown PhD.

Disclosures: Neil Boudville has previously received research funds from Roche, travel grants from Roche, Amgen and Jansen Cilag, and speaking honoraria from Roche. Wai Lim is on the Advisory Board for Novartis, Genzyme, Bristol Myer Squibb and Pfizer, he has also received research grants from Novartis, Genzyme and Pfizer, plus speaking honoraria from Novartis and Genzyme. David Johnson is a consultant for Baxter Healthcare Pty Ltd and Fresenius Medical Care and has previously received research funds from Baxter. He has also received speakers’ honoraria and research grants from Fresenius Medical Care and Baxter. Kym Bannister is a consultant for Baxter Healthcare Pty Ltd, on their Clinical Advisory Board and received speaking honoraria. Fiona Brown is a consultant for Baxter and Fresenius and has received travel grants from Amgen and Roche. Stephen McDonald has received speaking honoraria from AMGEN Australia, Fresenius Australia and Solvay Pharmaceuticals and travel grants from AMGEN Australia, Genzyme Australia and Jansen-Cilag. The remaining authors have no competing financial interests to declare.

The article, entitled “Recent Peritonitis Associates with Mortality Among Patients Treated with Peritoneal Dialysis,” will appear online at http://jasn.asnjournals.org/ on May 24, 2012, doi: 10.1681/ASN.2011121135.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, and with more than 13,500 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.

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Acute kidney injury affects 5% to 30% of heart surgery patients.

Newswise — Washington, DC (May 24, 2012) — Oxidative stress may put obese patients at increased risk of developing kidney damage after heart surgery, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). Effective antioxidants or other therapies that reduce oxidative stress might help lower this risk, particularly among obese patients.

Acute kidney injury (AKI), an abrupt decline in kidney function, is an increasingly prevalent and potentially serious condition following major surgery. Sometimes AKI arises after heart surgery because the kidneys are deprived of normal blood flow during the procedure.

To see if extra body weight puts patients at increased risk for developing AKI following heart surgery, Frederic Billings IV, MD (Vanderbilt University School of Medicine) and his colleagues evaluated information from 445 heart surgery patients, 112 of whom (25%) developed AKI.

Among the major findings:
• Obese patients (body mass index, or BMI, ?30 kg/m2) had an increased risk of developing AKI; specifically, a 26.5% increased risk per 5 kg/m2 increase in BMI.
• Oxidative stress, which generates harmful unstable reactive oxygen molecules, plays a role in the link between obesity and AKI.

“The identification of oxidative stress during surgery as a possible mechanism for the development of kidney injury following surgery provides an opportunity to develop and test therapeutic treatments for surgical patients,” said Dr. Billings.
Study co-authors include Mias Pretorius, MD, Jonathan Schildcrout, PhD, Nathaniel Mercaldo, John Byrne, MD, T. Alp Ikizler, MD, Nancy J. Brown, MD (Vanderbilt University School of Medicine).

Disclosures: The authors reported no financial disclosures.

The article, entitled “Obesity and Oxidative Stress Predict Acute Kidney Injury Following Cardiac Surgery,” will appear online at http://jasn.asnjournals.org/ on May 24, 2012, doi: 10.1681/ASN.2011090940.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, and with more than 13,500 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.

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