Thousands of Swedes with impaired renal function receive regular dialysis treatment. Four out of five have blood dialysis, which requires hospital visits several times a week. Other patients may have bag dialysis (peritoneal dialysis) - where the peritoneum is used to purify the blood - which they can manage themselves at home, either manually or automatically with the aid of machines. Now researchers at Lund University and Skåne University Hospital are working on developing a more effective treatment with the aim of simplifying everyday life for many dialysis patients.
"In previous studies, we have demonstrated in theory that it is possible to both make treatment more effective and reduce glucose absorption - a well-known side effect that leads to weight gain - in bag dialysis. Now, in both experimental and clinical studies, we will see whether our hypotheses hold. The conditions are so good that I am convinced that we will have a new treatment as standard in the clinic within five years,” says Carl Öberg, researcher in renal medicine and resident doctor.
"We expect to be able to optimise the treatment for those who have dialysis at home with a 30 per cent increase in treatment effect while reducing glucose absorption by 20-30 percent. This would mean 1 hour less treatment for the patient every night. This may not sound very much, but they can use that hour for something other than being tied to the dialysis machine.”
Carl Öberg also says that it could mean that more patients could have bag dialysis at home instead of blood dialysis, which involves three hospital sessions of about four hours each every week.
The reason that the majority of patients today have blood dialysis is that it is considered more effective than bag dialysis.
"If we can increase the effectiveness of bag dialysis there is much to be gained, including in terms of retained kidney function, because the bag dialysis is gentler. There are also great financial gains to be made. Bag dialysis costs society less than blood dialysis.”
The mathematical model developed by the researchers, which is now to be tested at the clinic, takes into account the individual circumstances of each patient in terms of treatment.
"Compared to the standard treatment we have had in the clinic for 40 years, this is a tailored treatment for each patient, where, with the aid of mathematics and a computer, we decide on a case-by-case basis which treatment is the best.”
Financiers: Konsul Thure Carlssons Minne, Gambro-Lundia AB (part of Baxter Healthcare) and the Faculty of Medicine at Lund/Malmö (ALF)
About 1 million Swedes have impaired renal function and approximately 10,000 are treated in active uremic
care, i.e. undergo regular dialysis treatment or have a kidney transplant.
Peritoneal dialysis (PD) is a more gentle form of dialysis in cardiovascular terms which the patient can perform at home. This promotes the patient's autonomy and self-participation in the treatment. PD is also a treatment that preserves renal function in better ways than blood dialysis and at a lower cost to society.
Automated PD, where the replacement of dialysis fluid is carried out automatically by a machine, is a treatment that the patient usually has at night. The patient connects up to a machine when he or she goes to bed. The machine handles the treatment during the night and the patient disconnects the machine in the morning.
Source: Carl Öberg