Risk of hospitalization, technique failure, and death with increased training duration in 3‐days‐a‐week home hemodialysis

Morin, C.; Gionest, Isabelle; Laurin, Louis-Philippe; Goupil, Rémi; Nadeau‐Fredette, Annie‐Claire

doi:10.1111/hdi.12956

Cited by 3 publications

(1 citation statement)

References 28 publications

(61 reference statements)

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“…These practices are thought to have contributed to the high rates of treatment continuation. Additionally, considering reports suggesting that the duration of training may be associated with technique survival [20], we included training duration as a covariate in our analysis, but no significant association (aHR 1.003, 95% CI 0.99-1.01, P = 0.15) was observed.…”

Section: Plos Onementioning

confidence: 99%

Long-term survival of patients receiving home hemodialysis with self-punctured arteriovenous access

Tomori,

Inoue,

Sugiyama

et al. 2024

PLoS ONE

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Objective To determine the long-term survival of patients receiving home hemodialysis (HHD) through self-punctured arteriovenous access. Methods We conducted an observational study of all patients receiving HHD at our facility between 2001 and 2020. The primary outcome was treatment survival, and it was defined as the duration from HHD initiation to the first event of death or technique failure. The secondary outcomes were the cumulative incidence of technique failure and mortality. Cox proportional hazard models were used to identify the predictive factors for treatment survival. Results A total of 77 patients (mean age, 50.7 years; 84.4% male; 23.4% with diabetes) were included. The median dialysis duration was 18 hours per week, and all patients self-punctured their arteriovenous fistula. During a median follow-up of 116 months, 30 treatment failures (11 deaths and 19 technique failures) were observed. The treatment survival was 100% at 1 year, 83.5% at 5 years, 67.2% at 10 years, and 34.6% at 15 years. Age (adjusted hazard ratio [aHR], 1.07) and diabetes (aHR, 2.45) were significantly associated with treatment survival. Cardiovascular disease was the leading cause of death, and vascular access-related issues were the primary causes of technique failure, which occurred predominantly after 100 months from HHD initiation. Conclusion This study showed a favorable long-term prognosis of patients receiving HHD. HHD can be a sustainable form of long-term kidney replacement therapy. However, access-related technique failures occur more frequently in patients receiving it over the long term. Therefore, careful management of vascular access is crucial to enhance technique survival.

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Section: Plos Onementioning

confidence: 99%

Long-term survival of patients receiving home hemodialysis with self-punctured arteriovenous access

Tomori,

Inoue,

Sugiyama

et al. 2024

PLoS ONE

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Home hemodialysis technique survival: insights and challenges

Tran,

Karadjian,

Chan

et al. 2023

BMC Nephrol

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Home hemodialysis (HHD) offers several clinical, quality of life and cost-saving benefits for patients with end-stage kidney disease. While uptake of this modality has increased in recent years, its prevalence remains low and high rates of discontinuation remain a challenge. This comprehensive narrative review aims to better understand what is currently known about technique survival in HHD patients, elucidate the clinical factors that contribute to attrition and expand on possible strategies to prevent discontinuation. With increasing efforts to encourage home modalities, it is imperative to better understand technique survival and find strategies to help maintain patients on the home therapy of their choosing. It is crucial to better target high-risk patients, examine ideal training practices and identify practices that are potentially modifiable to improve technique survival.

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