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Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications

Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this measurement...
Peritoneal Dialysis I: Introduction and Procedure01:30

Peritoneal Dialysis I: Introduction and Procedure

Peritoneal dialysis (PD) is a procedure that facilitates the exchange of solutes, waste products, electrolytes, and excess fluid between the blood in the peritoneal capillaries and a dialysis solution introduced into the peritoneal cavity.Principles of Peritoneal Dialysis (PD)Diffusion: Waste products such as urea and electrolytes move from high concentrations in the blood to low concentrations in the dialysate across the peritoneal membrane. This mechanism is driven by the concentration...
Dialysis01:27

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Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
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Implementing a home haemodialysis programme without adversely affecting a peritoneal dialysis programme.

Michael Copland1, Donna Murphy-Burke, Adeera Levin

  • 1British Columbia Renal Agency, Division of Nephrology, University of British Columbia, Vancouver, BC V5Z 1M9, Canada. michael.copland@vch.ca

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
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Introducing home hemodialysis programs does not negatively impact peritoneal dialysis growth. The study found stable peritoneal dialysis rates and minimal patient transfer, indicating successful integration of home hemodialysis.

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Published on: July 19, 2018

Area of Science:

  • Nephrology
  • Renal Replacement Therapy
  • Public Health Policy

Background:

  • Rising prevalence of stage 5 chronic kidney disease (CKD) increases dialysis care costs.
  • Home hemodialysis (HHD) is gaining traction due to high therapy costs.
  • Concerns exist regarding HHD program growth potentially impacting peritoneal dialysis (PD) programs.

Purpose of the Study:

  • To assess the impact of a new HHD program on an established PD program in British Columbia.
  • To analyze the growth rates of different dialysis modalities following HHD implementation.

Main Methods:

  • Utilized the provincial renal database (PROMIS) in British Columbia.
  • Tracked all dialysis patients before and after HHD program implementation.
  • Compared annual and overall growth rates for hospital hemodialysis, community hemodialysis, HHD, and PD.

Main Results:

  • Peritoneal dialysis program growth rates remained stable annually (7.84% vs. 7.34%) and overall (25.27% vs. 23.62%) post-HHD introduction.
  • HHD program growth primarily derived from community and in-hospital hemodialysis, not PD.
  • Low incidence (6.4%) of patients discontinuing PD within six months prior to HHD training.

Conclusions:

  • Provincial-level HHD program implementation can coexist with existing PD programs.
  • Successful HHD integration does not adversely affect PD program growth rates.
  • HHD expansion can be achieved without compromising PD services.