Spanish home hemodialysis experience
PDF (Español)
HTML (Español)
PDF

Keywords

Home hemodialysis
Spain
technical survival
uremic toxins.

How to Cite

1.
Pérez Alba A, Reque Santiváñez J, Vázquez Gómez M, Pons Prades R. Spanish home hemodialysis experience. Rev. Colomb. Nefrol. [Internet]. 2018 Aug. 9 [cited 2024 Mar. 28];5(2):127-36. Available from: https://revistanefrologia.org/index.php/rcn/article/view/307

Abstract

Background: There is currently a growing interest, worldwide, for the possibilities offered by home hemodialysis, which is more widespread in northern European countries, Canada, the United Kingdom, the United States, Australia and New Zealand. In Spain, it has grown very slowly, except in certain regions such as the province of Castellón, where we have placed special interest in the expansion of home dialysis techniques.

Objective: To describe the experience in the Home Hemodialysis program of the Hospital General de Castellón.

Methodology: Descriptive study of the patients included in the home hemodialysis program of the Hospital General de Castellón, from its beginning in January 2008 to December 2017.


Results: As a whole, we trained 41 patients, of whom 36 came to hemodialysis at home (short-day regimen). Age 58,3±13,4 years, Charlson index 4,1±1,6, 62 % men, 25,6 % with diabetes mellitus, 15,4 % with diagnosis of heart failure, 32 % with hemodialysis fistula, 38,5 % of working-age patients were active. We obtained a technical survival considering the event death+technical failure, censoring transplant of 79,4 % a year, 75,2 % at 2 years and 42,1 % at 5 years, resulting determinants of the event in the univariate
analysis: age, presence of diabetes mellitus and presence of heart failure, and only heart failure in the multivariate. The weekly reductions of phosphorus and beta-2-microglobulin were significantly greater with daily short hemodialysis with respect to on-line haemodiafiltration. Being the on-line hemodiafiltration superior in the weekly reduction from the 17800 daltons of myoglobin.

Conclusions: Home hemodialysis is a possible technique that offers the patient an adequate social-labor reintegration with good levels of weekly reduction of uraemic toxins and an acceptable technical survival over time.

https://doi.org/10.22265/acnef.0.0.307
PDF (Español)
HTML (Español)
PDF

References

1. United States Renal Data System. 2017 USRDS annual data report: Epidemiology of kidney disease in the United States. Bethesda, MD National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2017.

2. Sociedad Española de Nefrología. Grupo de trabajo de apoyo y promoción de la hemodiálisis domiciliaria en España. [Internet] 2018. Disponible en: http://www.senefro.org/modules.php?name=grupos&d_op=viewgroup&idgroup=12766

3. Mc Cormick BB, Chan CY, ORN Home Dialyisis Research Group. Striving to Achieve an Integrated Home Dialysis System: A Report from the Ontario Renal Network Home Dialysis Attrition Task Force. Clin J Am Soc Nephrol. 2018;13(3):468-470.
https://doi.org/10.2215/CJN.06900617

4. Walker RC, Blagg CR, Mendelssohn DC. Systems to cultivate suitable patients for home dialysis. Hemodial Int. 2015;19 Suppl 1:52-58. https://doi.org/10.1111/hdi.12203

5. Pérez Alba A, Slon Roblero F, Castellano Gasch S, Bajo Rubio MA. Barriers for the development of home haemodialysis in Spain. Spanish nephrologists survey. Nefrología. 2017;37(6):665-668.
https://doi.org/10.1016/j.nefroe.2017.10.006

6. Shah N, Quinn RR, Thompson S, Pauly RP. Can home hemodialysis and peritoneal dialysis programs coexist and grow together?. Perit Dial Int. 2017;37(6):591-594. https://doi.org/10.3747/pdi.2017.00101

7. Jayanti A, Nikam M, Ebah L, Dutton G, Morris J, Mitra S. Technique survival in home haemodialysis: a composite success rate and its risk predictors in a prospective longitudinal cohort from a tertiary renal network programme. Nephrol Dial Transplant. 2013;28(10):2612-2620. https://doi.org/10.1093/ndt/gft294

8. Rioux JP, Marshall MR, Faratro R, Hakim R, Simmonds R, Chan CT. Patient selection and training for home hemodialysis. Hemodial Int. 2015;19 Suppl 1:71-79. https://doi.org/10.1111/hdi.12254

9. Prakash S, Coffin R, Schold J, Lewis SA, Gunzler D, Stark S, et al. Travel distance and home dialysis rates in the United States. Perit Dial Int. 2014;34(1):24-32. https://doi.org/10.3747/pdi.2012.00234

10. Julián-Mauro JC, Cuervo J, Rebollo P, Callejo D. Situación laboral y costes indirectos en pacientes con insuficiencia renal: diferencias entre distintas modalidades de tratamiento renal sustitutivo. Nefrología 2013;33(3):333-341. https://doi.org/10.3265/
Nefrologia.pre2012.Dec.11767

11. Cornelis T, Tennankore KK, Goffin E, Rauta V, Honkanen E, ?zyilmaz A, et al. An international feasibility study of home haemodialysis in older patients. Nephrol Dial Transplant. 2014;29(12);2327-2333.
https://doi.org/10.1093/ndt/gfu260

12. Nadeau-Fredette AC, Hawley CM, Pascoe EM, Chan CT, Clayton PA, Polkinghorne KR, et al. An Incident Cohort Study Comparing Survival on Home Hemodialysis and Peritoneal Dialysis (Australia and New Zealand Dialysis and Transplantation Registry). Clin J Am Soc Nephrol. 2015;10(8):1397-1407. https://doi.org/10.2215/CJN.00840115

13. Pipkin M, Eggers PW, Larive B, Rocco MV, Stokes JB, Suri R, et al. Recruitment and training for home hemodialysis experience and lessons from the Nocturnal Dialysis Trial. Clin J Am Soc Nephrol. 2010;5(9):1614-1620. https://doi.org/10.2215/CJN.02440310

14. Faratro R, Jeffries J, Nesrallah GE, MacRae JM. The care and keeping of vascular access for home hemodialysispatients. Hemodial Int. 2015;19 Suppl 1:80-92. https://doi.org/10.1111/hdi.12242

15. Perl J, Nessim SJ, Moist LM, Wald R, Na Y Tennankore KK, et al. Vascular Access Type and Patient and Technique Survival in Home Hemodialysis Patients: The Canadian Organ Replacement Register. Am J Kidney Dis. 2016;67(2):251-259.
https://doi.org/10.1053j.ajkd.2015.07.032.

16. Weinhandl ED, Nieman KM, Gilbertson DT, Collins AJ. Hospitalization in daily home hemodialysis and matched thrice-weekly in-center hemodialysis patients. Am J Kidney Dis. 2015;65(1):98-108. https://doi.org/10.1053/j.ajkd.2014.06.015.

17. Suri RS, Li L, Nesrallah GE. The risk of hospitalization and modality failure with home dialysis. Kidney Int. 2015;88(2):360-368.
https://doi.org/10.1038/ki.2015.68

18. Lok CE, Sontrop JM, Faratro R, Chan CT, Zimmerman DL. Frequent hemodialysis fistula infectious complications. Nephron extra. 2014;4(3):159-167.

19. Muir CA, Kotwal SS, Hawley CM, Polkinghorne K, Gallagher MP, Snelling P, et al. Buttonhole cannulation and clinical outcomes in a home hemodialysis cohort and systematic review. Clin J AM Soc Nephrol. 2014;9(1):110-119. https://doi.org/10.2215/CJN.03930413

20. Flythe JE, Kimmel SE, Brunelli SM. Rapid fluid removal during dialysis is associated with cardiovascular morbility and mortality. Kidney Int. 2011;79(2):250-257. https://doi.org/10.1038/ki.2010.383

21. Maduell F. Eficacia depurativa de medianas y grandes moléculas en diferentes modalidades de hemodiálisis. Nefrología. 2005;25 Supl 2:15-18.

22. Ronco C. The rise of expanded hemodialyisis. Blood Purif. 2017;44(2):I-VIII. https://doi.org/10.1159/000476012
No national or foreign publication may partially or totally reproduce or translate Revista Colombiana de Nefrología articles or abstracts without prior written permission from the journal’s Editorial Board.

Dimensions


PlumX


Downloads

Download data is not yet available.