| Autor: |
Lavin, P., Connaughton, D. M., Ormond, J., Butler, A., O'Kelly, P., Kennedy, C., Conlon, P. J., Murray, S., Phelan, E., Young, J., Leavey, S., Durack, L., Lappin, D., Giblin, L., Flavin, J., Casserly, L., O'Grady, M., Plant, W. D. |
| Předmět: |
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| Zdroj: |
QJM: An International Journal of Medicine; Apr2018, Vol. 111 Issue 4, p225-229, 5p |
| Abstrakt: |
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. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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