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Home haemodialysis in Ireland.
C Kennedy1,2, D M Connaughton1, S Murray1,3
1Department of Nephrology, Beaumont Hospital, Dublin 9, Ireland.
QJM : Monthly Journal of the Association of Physicians
|December 23, 2017
Summary
Home haemodialysis (HHD) offers improved patient outcomes and resource management. The Irish HHD Programme showed favorable survival rates, though some patients require more dialysis education and psychosocial support.
Area of Science:
- Nephrology
- Renal Medicine
- Dialysis Technology
Background:
- Home haemodialysis (HHD) is gaining international attention for its potential benefits.
- HHD can positively influence patient outcomes and healthcare resource management.
Purpose of the Study:
- To review the activity and outcomes of the Irish Home Haemodialysis Programme.
- The review covered the period from the programme's inception in 2009 to 2016.
Main Methods:
- A retrospective review of patient data was conducted.
- Data were sourced from the national electronic Renal Patient database and individual center records.
- Statistical analysis was performed using Stata SE software.
Main Results:
- 101 patients completed training and started HHD; 45 were assessed but did not proceed.
- Switching to HHD increased weekly dialysis hours and reduced medication burden for most patients.
- Arteriovenous fistula (AVF) was the primary vascular access in 62% of patients; complications were mainly access-related.
Conclusions:
- Patient and technique survival rates for HHD were comparable to international benchmarks.
- Areas for improvement include targeted education for patients receiving inadequate dialysis and increased AVF and self-needling rates.
- Psychosocial support is crucial for patients transitioning between dialysis modalities.
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