Characteristics, practices, and outcomes in a Belgian cohort of incident home hemodialysis patients: A 6-year experience.

Autor: Vô B; Division of Nephrology, Cliniques universitaires Saint-Luc, Brussels, Belgium., Anthonissen B; Division of Nephrology, Cliniques universitaires Saint-Luc, Brussels, Belgium., Verger C; Registre de Dialyse Péritonéale de Langue française (RDPLF), Pontoise, France., Jadoul M; Division of Nephrology, Cliniques universitaires Saint-Luc, Brussels, Belgium.; Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium., Morelle J; Division of Nephrology, Cliniques universitaires Saint-Luc, Brussels, Belgium.; Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium., Goffin E; Division of Nephrology, Cliniques universitaires Saint-Luc, Brussels, Belgium.; Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.
Jazyk: angličtina
Zdroj: Hemodialysis international. International Symposium on Home Hemodialysis [Hemodial Int] 2022 Jul; Vol. 26 (3), pp. 295-307. Date of Electronic Publication: 2022 Apr 19.
DOI: 10.1111/hdi.13014
Abstrakt: Background: Home hemodialysis (HHD) remains underused in patients with kidney failure. Current literature on HHD mostly originates from non-European countries, making generalization difficult. The present study describes patients' profile and practice patterns from a Belgian HHD center, and assesses patient and technique survival and complications associated with HHD.
Methods: We analyzed data from all our incident patients during a 6-year period. The patient's characteristics were summarized using descriptive statistics. Transition to another therapeutic modality, estimated using a risk model with death and transplantation as competing events, episodes of respite cares and hospitalizations, and access complications were analyzed.
Results: Eighty patients (mean age: 47 years; male: 64%) met the inclusion criteria. Fifty-one percent of patients initiated dialysis with a central venous catheter (CVC) and 96% were not assisted. Arterio-venous fistula (AVF) cannulation was performed using buttonhole technique. Standard-frequent HD (47%) and short-frequent low-flow dialysate HD (34%) were mostly used at HHD initiation. Cumulative incidences of technique failure and death were 15%, 24%, and 32% at 1, 2, and 5 years. Incidence rates for respite dialysis and hospitalizations were 2.39 and 0.54 per patient-year of HHD. In comparison with AVF, incidence rate ratios of overall access complications and access-related infections for CVC were 4.3 (95% CI: 3.1-6, p < 0.01) and 4.4 (95% CI: 2.1-10, p < 0.01), respectively. Buttonhole cannulation was complicated by 0.26 (95% CI: 0.15-0.46) infections per 1000 AVF-days.
Conclusions: This present study provides important information about patient's profile and practice patterns and safety in a cohort of 80 incident Belgian HHD patients, with encouraging techniques and patient survival.
(© 2022 International Society for Hemodialysis.)
Databáze: MEDLINE
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