Home versus in-centre haemodialysis for end-stage kidney disease

Palmer, Suetonia C.; Palmer, Andrew R; Craig, Jonathan C.; Johnson, David W.; Stroumza, P.; Frantzen, L.; Leal, Miguel; Hoischen, Susanne; Hegbrant, Jörgen; Strippoli, Giovanni F.M.

doi:10.1002/14651858.cd009535.pub2

Cited by 14 publications

(5 citation statements)

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“…Although the majority of patients with ESRD receive in-center hemodialysis (HD), home dialysis modalities are being increasingly recommended as first-line renal replacement therapies [ 3 – 8 ]. Compared with in-center HD, home dialysis offers patients greater autonomy and improved quality of life at lower overall cost [ 9 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

Comparative Effectiveness of Home Dialysis Therapies: A Matched Cohort Study

Nesrallah

Suri

2016

Can J Kidney Health Dis

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BackgroundHome dialysis is being increasingly promoted among patients with end-stage renal disease, but the comparative effectiveness of home hemodialysis and peritoneal dialysis is unknown.ObjectiveTo determine whether patients receiving home daily hemodialysis have reduced mortality risk compared with matched patients receiving home peritoneal dialysis.DesignThis study is an observational, propensity-matched, new-user cohort study.SettingLinked electronic data were from the United States Renal Data System (USRDS) and a large dialysis provider’s database.PatientsThe patients were adults receiving in-center hemodialysis in the USA between 2004 and 2011 and registered in the USRDS.MeasurementsBaseline comorbidities, demographics, and outcomes for both groups were ascertained from the United States Renal Data System.MethodsWe identified 3142 consecutive adult patients initiating home daily hemodialysis (≥5 days/week for ≥1.5 h/day) and matched 2688 of them by propensity score to 2688 contemporaneous US patients initiating home peritoneal dialysis. We used Cox regression to compare all-cause mortality between groups.ResultsAfter matching, the two groups were well balanced on all baseline characteristics. Mean age was 51 years, 66 % were male, 72 % were white, and 29 % had diabetes. During 10,221 patient-years of follow-up, 1493/5336 patients died. There were significantly fewer deaths among patients receiving home daily hemodialysis than those receiving peritoneal dialysis (12.7 vs 16.7 deaths per 100 patient-years, respectively; hazard ratio (HR) 0.75; 95 % CI 0.68–0.82; p < 0.001). Similar results were noted with several different analytic methods and for all pre-specified subgroups.LimitationsWe cannot exclude residual confounding in this observational study.ConclusionsHome daily hemodialysis was associated with lower mortality risk than home peritoneal dialysis.Electronic supplementary materialThe online version of this article (doi:10.1186/s40697-016-0105-x) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Comparative Effectiveness of Home Dialysis Therapies: A Matched Cohort Study

Nesrallah

Suri

2016

Can J Kidney Health Dis

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“…The literature supports the effectiveness of home-based haemodialysis, with patients self-managing care involving complex clinical and technical tasks, such as inserting needles into a fistula or connecting a central catheter to the dialysis machine and injecting medications (Palmer et al, 2014). This may imply that increased patient involvement can be beneficial even within facility or hospital-based haemodialysis units.…”

Section: Backg Rou N Dmentioning

confidence: 95%

“…Patients with end-stage renal disease need to make considerable lifestyle changes, including dietary and fluid restrictions, a complicated medication regime, learning to recognise signs and symptoms associated with potential complications and, for patients on haemodialysis, care of vascular access (Roberti et al, 2018). The most common form of renal replacement therapy, haemodialysis, is most often provided in dialysis units several times a week for 3-to 5-h sessions, presenting a significant burden on patients, caregivers and healthcare systems (Palmer et al, 2014). Among the options of haemodialysis in many countries is home-based treatment, which is associated with improved outcomes such as survival, patient-reported quality of life and cost-effectiveness (Chan et al, 2019;Mitsides et al, 2016).…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…Institutional haemodialysis patients tend to be passive recipients of dialysis treatments, with dialysis units often functioning in a manner that reinforces patient passivity and dependency (Fotheringham et al, 2017). Although there are recent studies showing that self-management of haemodialysis care is related to better quality of life and longer survival, globally, the number of patients self-dialysing is low (Palmer et al, 2014). Additional research is needed regarding patient self-management in institutional haemodialysis settings in order to better understand patients and providers' perspectives on performance of various self-management tasks.…”

Section: Introductionmentioning

confidence: 99%

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Interest and perceived capability of self‐care in haemodialysis units

Kurtz

Geron

Shadmi

2020

Journal of Clinical Nursing

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Aims To (a) assess patients' interest and perceived capability of participating in haemodialysis; (b) assess nurses' perceptions of patients’ interest and perceived capability of participating in haemodialysis; and (c) examine associations between patient characteristics and interest and perceived capability of performing haemodialysis self‐care. Design Cross‐sectional, questionnaire‐based study. Methods Data were collected from dialysis patients and their nurses between October 2018–May 2019. Patients’ interest and perceived capability of participation were assessed by a 10‐item Likert‐type scale developed and tested for this study, with responses ranging from 1 (not interested/no perceived capability) to 5 (already doing task independently). Multivariate linear regression was used to assess the relationship between patient characteristics, including age, sex, education level and severity of illness to ratings of activation level and haemodialysis self‐care scale scores. The STROBE checklist was used as a guideline for this study. Results Ninety‐one patients and 31 nurses participated. Overall, patients expressed interest (2.43 ± 0.93) and perceived themselves capable (2.34 ± 0.9) of participating in various haemodialysis‐related tasks. Nurses assessed lower interest (2.19 ± 0.77) than patients, but similar average capability (2.31 ± 0.8). Both greater interest and perceived capability were correlated with more years of education and higher patient activation; additionally, interest was associated with disease severity and perceived capability was associated with age. Conclusion Haemodialysis patients are interested and perceive themselves capable of participating in the tasks involved in dialysis care. Nurses underestimate patient interest in participation. Relevance to clinical practice Self‐care behaviours among haemodialysis patients are important, as they may affect quality of life and survival. Determining interest and perceived capability of participation is a first step towards evaluating the feasibility of self‐care in a supervised haemodialysis setting.

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“… 2 In some patients, CKD eventually progress to end-stage renal disease (ESRD). 3 , 4 Patients with ESRD are prone to various complications, such as increased risk of cardiovascular disease, infection, malnutrition, metabolic diseases and impaired physical function, and maintenance hemodialysis (MHD) is required to remove toxins and excess fluid. 5–8 …”

Section: Introductionmentioning

confidence: 99%

Combination of Multiple Hemodialysis Modes: Better Treatment Options for Patients Under Maintenance Hemodialysis

Zhang¹,

Li²,

Zhao³

et al. 2021

TCRM

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Purpose Chronic renal failure has become a major public health concern and treatment strategies are urgently needed. We aimed to investigate whether combination of hemodialysis modes was superior to regular hemodialysis for patients under maintenance hemodialysis. Patients and Methods A total of 144 patients with end-stage renal failure (ESRF) were enrolled in this single-center retrospective study. Patients received regular hemodialysis (HD) were included in HD group (n=52), patients received regular HD plus hemodiafiltration (HDF) in HD/HDF group (n=47), patients received the combination of regular HD, HDF and hemoperfusion (HP) in HD/HDF/HP group (n=45). After 1-month and 24-months treatment, therapeutic effects were assessed in terms of nutritional status, control of complications, dialysis adequacy, mean arterial pressure (MAP), infection rate and living quality. Results When patients received 1-month treatment, there were no statistically significant differences among three groups. After 24-months treatment, patients in HD/HDF and HD/HDF/HP group presented with better dialysis adequacy, lower MAP and infection rate, higher serum albumin, hemoglobin and calcium levels, lower serum phosphorus and intact parathyroid hormone levels, lower incidence of malnutrition and the Hamilton Depression Scale score, higher the Barthel Index score than HD group ( P <0.05). The levels of calcium, phosphorus and intact parathyroid hormone in HD/HDF/HP group were lower than those in HD/HDF group ( P <0.05). Conclusion Our finding highly indicated that combination of hemodialysis modes was superior to regular HD for patients with ESRF in nutritional status, control of complications, dialysis adequacy, and living quality.

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Home versus in-centre haemodialysis for end-stage kidney disease

Cited by 14 publications

References 65 publications

Comparative Effectiveness of Home Dialysis Therapies: A Matched Cohort Study

Comparative Effectiveness of Home Dialysis Therapies: A Matched Cohort Study

Interest and perceived capability of self‐care in haemodialysis units

Combination of Multiple Hemodialysis Modes: Better Treatment Options for Patients Under Maintenance Hemodialysis

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