Starting a Home Hemodialysis Program: Single Center Experiences
| Autor: | R-M Taponen, Carola Grönhagen-Riska, R Muroma-Karttunen, Eero Honkanen |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male medicine.medical_specialty Urology medicine.medical_treatment Training time 030232 urology & nephrology Hemodialysis Home Nutritional Status Home Care Services Hospital-Based 030204 cardiovascular system & hematology Single Center Hospitals University 03 medical and health sciences 0302 clinical medicine Humans Medicine Intensive care medicine Dialysis Aged business.industry Home hemodialysis Mean age Middle Aged medicine.disease University hospital 3. Good health Self Care Nephrology Hypertension Physical therapy Kidney Failure Chronic Female Hemodialysis business Peritoneal Dialysis Kidney disease |
| Zdroj: | Scandinavian Journal of Urology and Nephrology. 36:137-144 |
| ISSN: | 1651-2065 0036-5599 |
| DOI: | 10.1080/003655902753679445 |
| Popis: | Home hemodialysis (HHD) has been used only in a minority of patients over past years although it may offer significant advantages over the other renal replacement therapies. This study describes the systems for and the initial results of starting a HHD program.A program for HHD was instituted at a university hospital having more than 20 years of experience in training patients for self-care hemodialysis. A working group designed the patient and partner education program, installations, water quality assurance, logistics, and control systems.Between May 1998 and May 2001, 37 patients with a mean age of 48.3 +/- 12.5 (24-71) years were trained for HHD (1.0 patient/month) the mean training time being 2.0 +/- 0.6 (1-3) months. Four patients had no helper at home. The dialysis schedules (timing, frequency, duration) were individualized at home 41% of the patients having more frequent and/or longer treatments (including long-slow night and daily short HHD). The weekly dialysis time increased from 13.9 +/- 1.5 (CI 13.4-14.4) initially to 15.5 +/- 3.7 (CI 14.2-16.7) h (p = 0.008) at the end of follow-up. Significantly (p0.05) increased serum creatinine concentration was observed during the follow-up suggesting for an increased muscle mass. Initially 32% and at the end of follow-up 60% of the patients required no antihypertensive drugs (p0.05). Seventeen of the 21 drop-outs were caused by renal transplantation and the most common causes necessitating hospital back-up were related to vascular access.In conclusion the HHD program started in a unit having experience on and commitment for training self-care hemodialysis enabled individualization of the dialysis schedules resulting in the institution of long-slow (night) and alternate day as well as daily HHD therapies. It improved the control of hypertension renal transplantation being the single most common cause of drop-out. |
| Databáze: | OpenAIRE |
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