Sp724benefits of a Satellite Haemodialysis Unit With an Extended Role : Experience From West Wales

Rees, Sarah; Timmis, Delyth; O'Donohoe, B; Aithal, Vandse S

doi:10.1093/ndt/gfv200.43

Cited by 2 publications

(5 citation statements)

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“…All satellite interventions evaluated the impact of a satellite HD unit on renal outcomes (Appendix Table A3). 33-40 All studies described a satellite HD unit “spoke” as remote to the main central HD unit “hub,” but closer to patients whose treatments were in the satellite facility. Studies that evaluated telehealth interventions in satellite HD units 28,30,31 are described in telehealth intervention, as the intervention in those studies was not the satellite clinic, but rather the telehealth system in the satellite clinic.…”

Section: Resultsmentioning

confidence: 99%

“…However, 1 study evaluated outcomes not only in stable HD patients with acute medical issues but also dialysis-dependent AKI treated in a satellite HD clinic. 37 This intervention decreased transfer to the non-satellite HD facility, decreased travel time for families of patients with AKI requiring HD. Mortality was not compared with a pre-intervention program level; however, mortality of patients with AKI requiring HD was comparable with the published standards.…”

Section: Resultsmentioning

confidence: 99%

“…Satellite HD units show comparable mortality with the published controls when treating dialysis-dependent AKI. 37 On the contrary, satellite HD shows improved survival in rural satellite HD cohorts compared with urban HD units (odds ratio [OR] 0.77, P < .0001) after correcting for multiple demographic and clinical factors. Hospitalization rates may be increased 38 or equivalent.…”

Section: Resultsmentioning

confidence: 99%

“…34,36 Improvements in QOL occurred in the dialysis stress domain and in the cost and time associated with transportation to HD. 34,37…”

Section: Resultsmentioning

confidence: 99%

“…All interventions in remote HD patients involved patients remaining in their community and the delivery of HD services either at 28,43 or close to their home. 33-41 The provision of HD in units closer to a patient’s home associated with improved dialysis clearance, 38,39 QOL, 33,36,38 and survival. 40 However, the health care-associated costs of care may be higher than in-center HD, depending on the operating capacity of the satellite HD unit and transportation costs.…”

Section: Discussionmentioning

confidence: 99%

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Interventions to Improve Clinical Outcomes in Indigenous or Remote Patients With Chronic Kidney Disease: A Scoping Review

Ovtcharenko

Thomson

2019

Can J Kidney Health Dis

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Background:Chronic kidney disease (CKD) associates with a significant health care burden with a disproportionate impact on indigenous persons or people living in remote areas. Although screening programs have expanded in these communities, there remains a paucity of evidence-based interventions to enhance clinical renal outcomes in these populations.Objective:The objective of this study was to identify evidence-based interventions to enhance renal outcomes in these populations.Design:A scoping review was conducted for studies in the Cochrane, MEDLINE, and Embase databases and from major nephrology meetings.Setting:Chronic kidney disease, including those on dialysis.Patients:Remote or indigenous populationsMeasurements:Studies that performed an intervention that was followed by measurement of renal outcomes or patient-centered outcomes (ie, quality of life) were included.Methods:All studies were described by study type, intervention, and clinical outcome, and trends were identified by both authors. Meta-analysis was not conducted due to study heterogeneity.Results:Thirty-two studies met inclusion criteria, only 2 (6.3%) of which were randomized controlled trials. Intervention types included multidisciplinary (34.4%), satellite (32.3%), telehealth (25.0%), or other (9.4%). All multidisciplinary interventions were performed in the CKD (non-dialysis) setting and reported improved patient travel time, waiting time, quality of life, kidney function, proteinuria, and blood pressure. Telehealth interventions improved program cost, patient attendance, hospitalization, and quality of life. Satellite interventions were performed in the hemodialysis setting, with 1 study evaluating acute hemodialysis. Satellite interventions improved patient travel time, dialysis clearance, quality of life, and survival, but increased program costs.Limitations:The study was restricted to interventional trials assessing clinical outcomes and to studies in developed countries, which likely excluded some research contributing to this field.Conclusions:There is significant heterogeneity among studies of interventions for patients with CKD who are indigenous or live remotely. Interventions were more likely to be successful when the remote or indigenous community was included in program development, with a culturally safe approach. More large, high-quality studies are needed to identify effective interventions to enhance clinical renal outcomes in indigenous or remote populations.Trial Registration:This trial is registered under PROSPERO, Registration Number 128453.

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