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Related Experiment Videos

Starting a home hemodialysis program: single center experiences.

Eero Honkanen1, R Muroma-Karttunen, R-M Taponen

  • 1Department of Medicine, Division of Nephrology, Helsinki University Cerntral Hospital, Kasarmikatu 11-13, FI-00130 Helsinki, Finland. eero.honkanen@hus.fi

Scandinavian Journal of Urology and Nephrology
|June 12, 2002
PubMed
Summary

Home hemodialysis (HHD) offers advantages, with a new program enabling individualized dialysis schedules. This approach improved hypertension control and increased dialysis time for patients.

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Area of Science:

  • Nephrology
  • Renal Replacement Therapy
  • Home Hemodialysis

Background:

  • Home hemodialysis (HHD) is underutilized despite potential benefits over other renal replacement therapies.
  • A university hospital with extensive self-care hemodialysis training experience initiated an HHD program.

Purpose of the Study:

  • To describe the systems and initial outcomes of establishing a new Home Hemodialysis program.
  • To assess the feasibility and impact of individualized HHD schedules.

Main Methods:

  • Instituted an HHD program at a university hospital with over 20 years of self-care hemodialysis training experience.
  • Designed patient/partner education, installation protocols, water quality assurance, logistics, and control systems.
  • Trained 37 patients for HHD between May 1998 and May 2001, with individualized dialysis schedules.

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Main Results:

  • Mean training time was 2.0 months; 41% of patients received more frequent and/or longer dialysis sessions.
  • Weekly dialysis time increased significantly (p=0.008), and serum creatinine rose, suggesting increased muscle mass.
  • Hypertension control improved, with non-use of antihypertensive drugs increasing from 32% to 60% (p<0.05).
  • Renal transplantation was the primary reason for drop-out (17/21), with vascular access issues causing most hospital back-ups.

Conclusions:

  • An experienced unit's HHD program facilitated individualized dialysis schedules, including long-slow, alternate-day, and daily HHD.
  • The program successfully improved hypertension management in HHD patients.
  • Renal transplantation was the main cause for patients discontinuing HHD.