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Barriers to Home Haemodialysis
Aled Lloyd1, Helen Jefferies1, Rhodri Pyart1
1University Hospital of Wales, Cardiff, UK.
Blood Purification
|October 9, 2022
Summary
Most patients preferring home haemodialysis (HHD) do not receive it. Reversible barriers like poor communication and training delays prevent HHD initiation, impacting renal replacement therapy choices.
Area of Science:
- Nephrology
- Renal Replacement Therapy
- Dialysis Modalities
Background:
- Home haemodialysis (HHD) prevalence varies significantly across UK renal centres.
- The study's centre reported a 2% HHD prevalence, necessitating an investigation into patient outcomes and barriers.
Purpose of the Study:
- To determine the proportion of patients who successfully initiate HHD after choosing it as their preferred renal replacement therapy (RRT).
- To identify and analyze the barriers preventing patients from starting HHD.
Main Methods:
- Retrospective single-centre analysis of electronic medical records.
- Data collected included patient demographics, comorbidity, frailty, RRT events, and specific barriers to HHD.
Main Results:
- Out of 116 patients who preferred HHD, only 28 (24%) received it.
- No significant demographic or comorbidity differences were found between those who received HHD and those who received only unit haemodialysis (UHD).
- Key barriers included patient choice changes, clinical condition changes, transplantation, home environment issues, vascular access problems, and training delays.
Conclusions:
- A majority of patients opting for HHD do not ultimately receive this treatment.
- Potentially reversible barriers, such as communication breakdowns and insufficient training support, hinder HHD initiation.
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