Barriers for implementation of intensified hemodialysis: survey results from the International Pediatric Dialysis Network
| Autor: | Dagmara Borzych-Duzalka, Julia Thumfart, Franz Schaefer, Anuradha Jayanti, Steffen Wagner, Bradley A. Warady, Claus Peter Schmitt, Dominik N. Müller |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Nephrology medicine.medical_specialty Pediatric dialysis Attitude of Health Personnel medicine.medical_treatment 030232 urology & nephrology Survey result 030204 cardiovascular system & hematology Nephrologists 03 medical and health sciences 0302 clinical medicine Quality of life (healthcare) Renal Dialysis Surveys and Questionnaires Internal medicine medicine Home dialysis Humans In patient Registries Practice Patterns Physicians' Child Intensive care medicine Aged business.industry Middle Aged Pediatrics Perinatology and Child Health Kidney Failure Chronic Hemodialysis business |
| Zdroj: | Pediatric Nephrology. 33:705-712 |
| ISSN: | 1432-198X 0931-041X |
| DOI: | 10.1007/s00467-017-3831-0 |
| Popis: | In patients on conventional hemodialysis (HD), morbidity is high and quality of life is poor. Intensified HD programs have been developed to help overcome these shortcomings, , but very few pediatric dialysis centers have reported the implementation of such a HD program.An online survey was sent to all 221 pediatric dialysis centers which participate in the International Pediatric Dialysis Network (IPDN). The aim of the survey was to assess the attitude of pediatric nephrologists towards intensified HD, the penetrance of intensified HD into their clinical practice and barriers to implementation.Of the 221 pediatric dialysis centers sent the survey, respondents from 61% (134) replied. Among these respondents, 69% acknowledged being aware of the evidence in support of the use of intensified HD, independent of whether intensified HD was offered at their own center, and 50% associated the use of daily nocturnal HD with the best overall patient outcome. In contrast, only 2% of respondents were in favor of conventional HD. Overall, 38% of the respondents stated that at their center intensified HD is prescribed to a subgroup of patients, most commonly in the form of short daily HD sessions. The most important barriers to expansion of intensified HD programs were lack of adequate funding (66%) and shortage of staff (63%), whereas lack of expertise and of motivation were reported infrequently as obstacles (21 and 14%, respectively).Intensified HD is considered by many pediatric nephrologists to be the dialysis modality most likely associated with the best patient outcome. The limited use of this treatment approach highlights the importance of defining and successfully addressing the barriers to implementation. |
| Databáze: | OpenAIRE |
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