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[Guy's Hospital home dialysis program (author's transl)]
Insights
Home dialysis, initiated in 1968, has treated 141 patients. While many adults returned to work, social and sexual restrictions persist, and future services may be reduced due to financial constraints.
Area of Science:
- Nephrology
- Renal Replacement Therapy
- Public Health
Context:
- Home dialysis was first performed in 1968.
- 141 patients have undergone home dialysis since its inception.
- Patient ages ranged from 4 to 64 years.
Purpose:
- To evaluate the outcomes and challenges of home dialysis.
- To assess patient rehabilitation and quality of life.
- To consider the future of home dialysis in light of National Health Service financial constraints.
Summary:
- 24 deaths occurred, attributed to various complications and patient/staff discipline issues.
- Of 60 adult patients, 52 returned to work, with 6 showing potential for full rehabilitation.
- Significant social and sexual activity restrictions impact patients' quality of life.
Impact:
- Home dialysis offers rehabilitation potential but faces challenges.
- Financial limitations may lead to reduced home dialysis and increased kidney transplantation.
- Further research is needed to optimize home dialysis protocols and patient support.
Abstract:
The first home dialysis was carried out from Guy's Hospital in London in 1968. Since then, 141 patients have been treated in this manner. The age of the patients ranged from 4 to 64 years. 24 patients have died (cerebrovascular accidents, myocardial infarction, pulmonary edema, sepsis, peritonitis, hyperkalemia etc.). Some of the deaths were due to a slackening of discipline on the part of the patients and nursing staff during the years of constant dialysis. Of 60 adults 52 were able to start work again; full rehabilitation still seems possible in 6 cases. Nevertheless, many patients cannot lead a normal life because their social and sexual activity is greatly restricted. The present economic crisis led to financial limitations in the National Health Service. In future, home dialysis may have to be reduced and more transplantations performed.