Regular physical activity is not only associated with longer life expectancy in patients on hemodialysis but also reduces heart-related deaths. These results came from a new study done on 6147 European and Argentinian patients receiving hemodialysis. Physical activity was defined as participating in lifestyle activities such as work, household chores, travel, or leisure. Heart-related deaths included sudden death, heart attack, atherosclerotic heart disease, cardiac arrhythmia, cardiac arrest, valvular heart disease, pulmonary edema, and congestive heart failure.

Occasional physical activity was associated with a 20% lower risk for overall deaths and an 18% lower risk for heart-related deaths. Frequent physical activity was associated with an 18% lower risk for overall deaths and a 23% lower risk for heart-related deaths. As physical activity increased, the risk for heart-related deaths significantly decreased. Investigators adjusted results for patients’ diets. These results suggest that even low levels of physical activities that are likely to be safe yield a significant improvement in lowering the risk for death in these patients,” Dr. Bernier-Jean’s team concluded. This study also encourages future randomized controlled trials of low-intensity physical activity for sedentary adults receiving hemodialysis.

A hospital research team from Lawson Health Research Institute has found that expanded dialysis can improve the quality of life in chronic kidney disease patients who struggle with the side effects of traditional dialysis. Expanded dialysis is a new method that removes a broader range of toxins from the body than traditional dialysis. This study was conducted for three months with 28 patients.

The new dialyzer that was used in the study has precisely made pores that allow larger-sized toxic chemicals to be filtered from the blood while retaining essential molecules such as albumin. The chemicals that can now be filtered out can cause inflammation, malnutrition, and chronic symptoms like fatigue. Traditional dialysis treatments haven’t been as successful at removing those chemicals and some patients experienced significant side effects.

One of the study participants with chronic kidney disease had been on dialysis for about five years. He was complaining of reduced appetite, weakness, and reduced quality of sleep. He reported feeling better, improved appetite eating, and improved quality of sleep with expanded dialysis.

With the first phase of this study has been completed and published in Kidney Medicine, the next phase will include 60 dialysis patients for up to six months of treatments using the new dialyzer. This second phase will be a multicentered clinical study led by Lawson, University of Toronto, and Humber College.

FDA gives thumbs down to Tenapanor for control of Phosphorus in kidney patients on dialysis

The US Food and Drug Administration (FDA) has asked for an additional clinical trial to demonstrate the benefits of Tenapanor before it can approve the drug. Tenapanor has shown good prospects in trials for the control of serum phosphorus in adults with chronic kidney disease (CKD) on dialysis. Tenapanor is an oral drug that inhibits the sodium-proton exchanger NHE3. The drug was submitted for approval to treat hyperphosphatemia in patients with CKD on dialysis. The data is supported by three phase-3 clinical trials involving more than 1000 patients.

The FDA stated that approval of the application would require the drug manufacturer to conduct an additional “adequate and well-controlled trial demonstrating a clinically relevant treatment effect on serum phosphorus or an effect on the clinical outcome thought to be caused by hyperphosphatemia in CKD patients on dialysis.”

Patients receiving dialysis for the management of CKD are highly likely to be hyperphosphatemic. Current Therapies for Hyperphosphatemia are only moderately effective and difficult to implement. Current strategies for the management of hyperphosphatemia include more frequent hemodialysis, dietary phosphate restriction, and phosphate binder therapy. Untreated, hyperphosphatemia can lead to dystrophic calcification, accelerated arteriosclerotic vascular disease, and fractures.

In a study, 236 patients who were on dialysis and had hyperphosphatemia despite treatment with phosphate binder therapy were given 4 weeks of treatment with either the twice-daily oral Tenapanor or placebo. The results showed that the Tenapanor treatment group had a significantly greater change in serum phosphorus concentration versus placebo.

Tenapanor has previously received FDA approval in 2019 for the treatment of irritable bowel syndrome (IBS) with constipation in adults.