Home haemodialysis in Ireland.
QJM
; 111(4): 225-229, 2018 Apr 01.
Article
in En
| MEDLINE
| ID: mdl-29272506
ABSTRACT
BACKGROUND:
Home haemodialysis (HHD) has the potential to impact positively on patient outcomes and health resource management. There has been rejuvenated international interest in HHD in recent years.AIM:
We aimed to review the activity and outcomes of the Irish HHD Programme since inception (2009-16).DESIGN:
Retrospective review.METHODS:
Patient data were collected using the national electronic Renal Patient database (eMEDRenal version 3.2.1) and individual centre records. All data were recorded in a coded fashion on a Microsoft Excel Spread-sheet and analysed with Stata SE software.RESULTS:
One hundred and one patients completed training and commenced HHD; a further fourty-five patients were assessed for HHD suitability but did not ultimately dialyse at home. Twenty patients switched to nocturnal HHD when this resource became available. The switch from conventional in-centre dialysis to HHD led to an increase in the mean weekly hours on haemodialysis (HD) and a reduction in medication burden for the majority of patients. The overall rate of arteriovenous fistula (AVF) as primary vascular access was 62%. Most HHD complications were related to access function or access-related infection. Over the 7-years, 29 HHD patients were transplanted and 9 patients died. No deaths resulted directly from a HHD complication or technical issue.CONCLUSIONS:
Patient and technique survival rates compared favourably to published international reports. However, we identified several aspects that require attention. A small number of patients were receiving inadequate dialysis and require targeted education. Ongoing efforts to increase AVF and self-needling rates in HD units must continue. Psychosocial support is critical during the transition between dialysis modalities.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Hemodialysis, Home
/
Kidney Failure, Chronic
Type of study:
Observational_studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
QJM
Journal subject:
MEDICINA
Year:
2018
Document type:
Article
Affiliation country: