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Home haemodialysis

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https://www.readbyqxmd.com/read/29664189/hydration-and-nutritional-status-in-patients-on-home-dialysis-a-single-centre-study
#1
Janet S C Li, John Y H Chan, Mandy M Y Tai, So M Wong, S M Pang, Fanny Y F Lam, Carmen H M Chu, Chris S Y Ching, Joseph H S Wong, W L Chak
BACKGROUND: Over-hydration (OH) and malnutrition are prevalent among patients on dialysis therapy. The prevalence of OH and malnutrition as well as the risk factors associated with OH and malnutrition in our patients on home peritoneal dialysis (PD) and home haemodialysis (HD) are examined. DESIGN AND METHODS: This was a cross-sectional study. The hydration and nutritional status of the study groups were assessed by a Body Composition Monitor. Patients who were stable on home dialysis therapy for over one year were invited to participate...
April 17, 2018: Journal of Renal Care
https://www.readbyqxmd.com/read/29664179/developing-and-pilot-testing-a-shared-decision-making-intervention-for-dialysis-choice
#2
Jeanette Finderup, Jens K D Jensen, Kirsten Lomborg
BACKGROUND: Evidence is inconclusive on how best to guide the patient in decision-making around haemodialysis and peritoneal dialysis choice. International guidelines recommend involvement of the patient in the decision to choose the dialysis modality most suitable for the individual patient. Nevertheless, studies have shown lack of involvement of the patient in decision-making. OBJECTIVES: To develop and pilot test an intervention for shared decision-making targeting the choice of dialysis modality...
April 17, 2018: Journal of Renal Care
https://www.readbyqxmd.com/read/29658218/-burden-of-healthcare-associated-infections-in-outpatient-care
#3
Walter Zingg, Aliki Metsini, Qiao Fu, Diana Neves, Didier Pittet
There is little evidence on healthcare-associated infections in outpatient care. The Swiss Federal Office for Public Health commissioned a systematic review to estimate the incidence of healthcare-associated infections in non-institutional settings. A total of 126 papers were eligible for data abstraction. The identified reports and studies were heterogeneous and generally of low quality. The main outcomes were surgical site infections, central venous catheter-related bloodstream infections, and urinary tract infections...
April 11, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29656667/haemodialysis-at-home-review-of-current-dialysis-machines
#4
Sabrina Haroon, Andrew Davenport
Only a minority of patients with chronic kidney disease treated by hemodialysis are currently treated at home. Until relatively recently, the only type of hemodialysis machine available for these patients was a slightly smaller version of the standard machines used for in-center dialysis treatments. Areas covered: There are now an alternative generation of dialysis machines specifically designed for home hemodialysis. The home dialysis patient wants a smaller machine, which is intuitive to use, easy to trouble shoot, robust and reliable, quick to set-up and put away, requiring minimal waste disposal...
April 14, 2018: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/29562840/vascular-access-for-home-haemodialysis
#5
Julien Al Shakarchi, C Day, N Inston
INTRODUCTION: Home haemodialysis has been advocated due to improved quality of life. However, there are very little data on the optimum vascular access for it. METHOD: A retrospective cohort study was carried on all patients who initiated home haemodialysis between 2011 and 2016 at a large university hospital. Access-related hospital admissions and interventions were used as primary outcome measures. RESULTS: Our cohort consisted of 74 patients...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29512320/severe-methanol-poisoning-with-neurological-sequelae-implications-for-diagnosis-and-management
#6
Nicolette R Holt, Christopher P Nickson
A 22-year-old woman presented with methanol toxicity manifesting as headache, reduced conscious state and visual change after consuming home-made grappa. She progressed to a coma with fixed mydriasis and severe acidaemia (pH 6.55). She was treated with empirical antidote administration (intravenous ethanol) and enhanced elimination through haemodialysis. She survived despite her delayed presentation but developed significant neurological sequelae, including visual impairment. We provide an overview of key elements of diagnosis and recent updates in treatment recommendations...
March 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29508505/how-an-ordeal-becomes-the-norm-a-qualitative-exploration-of-experiences-of-self-cannulation-in-male-home-haemodialysis-patients
#7
Currie Moore, Rabiya Majeed-Ariss, Anuradha Jayanti, Sandip Mitra, Suzanne Skevington, Alison Wearden
OBJECTIVES: Despite home haemodialysis (HHD) being associated with significant health and psychosocial benefits, it remains an under-utilized dialysis modality for people with chronic kidney disease. Self-cannulation, where patients insert their own needles for dialysis, is a key component of HHD. Recent research suggests that the prospect of self-cannulation is a barrier for patients, but there is little research which examines why this is the case. The aim of this study was to explore male HHD patients' experiences and attitudes towards self-cannulation...
March 6, 2018: British Journal of Health Psychology
https://www.readbyqxmd.com/read/29391354/metformin-associated-lactic-acidosis-mimicking-ischaemic-bowel
#8
Sajjad Ali, Heloise Labuschagne, Nickolay Azarov, Zakaria Hindi, Lavi Oud
Metformin-associated lactic acidosis (MALA) is a rare complication among patients who are diabetic, commonly presenting with non-specific findings, and developing mostly among those with other risk factors for lactic acidosis. We report the development of MALA in a 67-year-old man with diabetes who presented with progressive abdominal pain and bloody diarrhoea. On presentation the patient was in shock, with signs suggestive of peritonitis, and with severe lactic acidosis, renal failure and non-specific findings on abdominal CT...
February 1, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29178891/rationale-and-design-for-sharehd-a-quality-improvement-collaborative-to-scale-up-shared-haemodialysis-care-for-patients-on-centre-based-haemodialysis
#9
James Fotheringham, Tania Barnes, Louese Dunn, Sonia Lee, Steven Ariss, Tracey Young, Stephen J Walters, Paul Laboi, Andy Henwood, Rachel Gair, Martin Wilkie
BACKGROUND: The study objective is to assess the effectiveness and economic impact of a structured programme to support patient involvement in centre-based haemodialysis and to understand what works for whom in what circumstances and why. It implements a program of Shared Haemodialysis Care (SHC) that aims to improve experience and outcomes for those who are treated with centre-based haemodialysis, and give more patients the confidence to dialyse independently both at centres and at home...
November 24, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28869959/screening-of-cognitive-impairment-in-the-dialysis-population-a-scoping-review
#10
Aye San, Balaji Hiremagalur, Wendy Muircroft, Laurie Grealish
BACKGROUND: Cognitive impairment in end-stage kidney disease patients on dialysis is increasingly common. This study aimed to review the practice of screening and to evaluate the evidence on cognitive impairment prevalence in this population. METHODS: This scoping review of studies summarises the evidence on cognitive impairment in dialysis populations. The search included the Medline, CINAHL, Embase, PsycINFO, PubMed, and Cochrane Library databases for English-language articles published between 2000 and 2015...
2017: Dementia and Geriatric Cognitive Disorders
https://www.readbyqxmd.com/read/28666310/effectiveness-of-self-management-support-in-maintenance-haemodialysis-patients-with-hypertension-a-pilot-cluster-randomized-controlled-trial
#11
Baoyan Huang, Zheng Li, Ying Wang, Jinghua Xia, Tao Shi, Jingmei Jiang, Nolan T Marie, Xuemei Li, Sagar U Nigwekar, Limeng Chen
BACKGROUND: Uncontrolled hypertension is an independent risk factor for cardiovascular disease and is the leading cause of mortality in haemodialysis patients. The aim of this study was to examine the effectiveness of self-management support SMS) for blood pressure (BP) control and health behaviors. METHODS: We conducted a cluster randomized controlled trial (RCT) in which 90 adult haemodialysis patients were assigned to either an SMS or common intervention (CI) group...
June 30, 2017: Nephrology
https://www.readbyqxmd.com/read/28614637/renal-telemedicine-through-video-as-a-service-delivered-to-patients-on-home-dialysis-a-qualitative-study-on-the-renal-care-team-members-experience
#12
Jae-Llane Ditchburn, Alison Marshall
BACKGROUND: The Lancashire Teaching Hospitals NHS Trust in the UK has been providing renal care through video-as-a-service (VAAS) to patients since 2013, with support from the North West NHS Shared Infrastructure Service, a collaborative team that supports information and communication technology use in the UK National Health Service. INTRODUCTION: Renal telemedicine offered remotely to patients on home dialysis supports renal care through the provision of a live high-quality video link directly to unsupported patients undergoing haemodialysis at home...
September 2017: Journal of Renal Care
https://www.readbyqxmd.com/read/28555652/reducing-the-costs-of-chronic-kidney-disease-while-delivering-quality-health-care-a-call-to-action
#13
REVIEW
Raymond Vanholder, Lieven Annemans, Edwina Brown, Ron Gansevoort, Judith J Gout-Zwart, Norbert Lameire, Rachael L Morton, Rainer Oberbauer, Maarten J Postma, Marcello Tonelli, Wim Van Biesen, Carmine Zoccali
The treatment of chronic kidney disease (CKD) and of end-stage renal disease (ESRD) imposes substantial societal costs. Expenditure is highest for renal replacement therapy (RRT), especially in-hospital haemodialysis. Redirection towards less expensive forms of RRT (peritoneal dialysis, home haemodialysis) or kidney transplantation should decrease financial pressure. However, costs for CKD are not limited to RRT, but also include nonrenal health-care costs, costs not related to health care, and costs for patients with CKD who are not yet receiving RRT...
July 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28413966/the-clinical-problems-of-hypertension-treatment-in-hemodialysis-patients
#14
Charalampos N Loutradis, Costas Tsioufis, Pantelis A Sarafidis
Hypertension (HT) is present in more than 80% of patients undergoing Hemodialysis (HD). Elevated Blood Pressure (BP) in hemodialysis patients is associated with cardiovascular events and mortality only when BP is recorded with home or ambulatory monitoring, since pre- and post-dialysis measurements are not valid estimates of BP levels during the interdialytic interval. Sodium and water overload is the most important of several mechanisms involved in HT development in HD. In this context, non-pharmacologic measures to ensure water and sodium balance by achieving patient dry weight and decreasing daily sodium intake, through modification of sodium level in the diet or in dialysis dialysate, are fundamental for HT control...
2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28396745/multidisciplinary-staff-attitudes-to-home-haemodialysis-therapy
#15
Anuradha Jayanti, Philip Foden, Sandip Mitra
Background: More than a decade after the National Institute for Health and Clinical Excellence recommendation of home haemodialysis (home HD) for 10-15% of those needing renal replacement therapy, the uptake across different regions in the UK remains uneven. Methods: This survey is part of the Barriers to Successful Implementation of Care in Home Haemodialysis (BASIC-HHD) study, an observational study of patient and organizational factor barriers and enablers of home HD uptake, in the UK. The study centres had variable prevalence of home HD by design [low: <3% (2), medium: 5-8% (2) and high: >8% (1)]...
April 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28340239/hypertension-in-dialysis-patients-a-consensus-document-by-the-european-renal-and-cardiovascular-medicine-eureca-m-working-group-of-the-european-renal-association-european-dialysis-and-transplant-association-era-edta-and-the-hypertension-and-the-kidney-working
#16
REVIEW
Pantelis A Sarafidis, Alexandre Persu, Rajiv Agarwal, Michel Burnier, Peter de Leeuw, Charles J Ferro, Jean-Michel Halimi, Gunnar H Heine, Michel Jadoul, Faical Jarraya, Mehmet Kanbay, Francesca Mallamaci, Patrick B Mark, Alberto Ortiz, Gianfranco Parati, Roberto Pontremoli, Patrick Rossignol, Luis Ruilope, Patricia Van der Niepen, Raymond Vanholder, Marianne C Verhaar, Andrzej Wiecek, Gregoire Wuerzner, Gérard M London, Carmine Zoccali
In patients with end-stage renal disease (ESRD) treated with haemodialysis or peritoneal dialysis, hypertension is common and often poorly controlled. Blood pressure (BP) recordings obtained before or after haemodialysis display a J- or U-shaped association with cardiovascular events and survival, but this most likely reflects the low accuracy of these measurements and the peculiar haemodynamic setting related to dialysis treatment. Elevated BP detected by home or ambulatory BP monitoring is clearly associated with shorter survival...
April 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28278361/the-effects-of-a-nurse-supervised-home-exercise-programme-on-improving-patients-perceptions-of-the-benefits-and-barriers-to-exercise-a-randomised-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
Xingjuan Tao, Susan Ka Yee Chow, Frances Ky Wong
AIMS AND OBJECTIVES: To explore the effects of a home exercise programme on patients' perceptions of the barriers and benefits to exercise and adherence to the programme. BACKGROUND: Great efforts have been made to encourage dialysis patients to participate in rehabilitation regimens. The promotion of exercise in this population is still limited. DESIGN: This was a post hoc analysis of a randomised, two-group parallel study. METHODS: A total of 113 adult patients recruited from the haemodialysis units were randomised into two groups on a 1:1 ratio...
September 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28269260/localised-impedance-monitoring-device-for-the-remote-clinical-assessment-of-home-based-dialysis-patients
#18
A Montalibet, W Arkouche, P Bogonez Franco, S Bonnet, A Clarion, G Delhomme, C Gehin, S Gharbi, R Guillemaud, P Jallon, B Massot, P Pham, E Ribbe-Cornet, E McAdams
BioImpedance Spectroscopy (BIS) has been clinically used to determine the hydrational status of patients undergoing haemodialysis (HD). In the present project we are developing a calf-localised, integrated impedimetric device to periodically and conveniently measure and transmit information on the hydrational status of home-based patients to a remote clinic. Surprisingly, we have found that simple postural changes before or during measurement lead to significant fluid shifts in the lower leg that are as important and as long lasting as the effects of haemodialysis...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227494/localised-impedance-monitoring-device-for-the-remote-clinical-assessment-of-home-based-dialysis-patients
#19
A Montalibet, W Arkouche, P Bogonez Franco, S Bonnet, A Clarion, G Delhomme, C Gehin, S Gharbi, R Guillemaud, P Jallon, B Massot, P Pham, E Ribbe-Cornet, E McAdams, A Montalibet, W Arkouche, P Bogonez Franco, S Bonnet, A Clarion, G Delhomme, C Gehin, S Gharbi, R Guillemaud, P Jallon, B Massot, P Pham, E Ribbe-Cornet, E McAdams, B Massot, P Pham, A Montalibet, P Jallon, E Ribbe-Cornet, P Bogonez Franco, G Delhomme, S Bonnet, R Guillemaud, W Arkouche, A Clarion, C Gehin, S Gharbi, E McAdams
BioImpedance Spectroscopy (BIS) has been clinically used to determine the hydrational status of patients undergoing haemodialysis (HD). In the present project we are developing a calf-localised, integrated impedimetric device to periodically and conveniently measure and transmit information on the hydrational status of home-based patients to a remote clinic. Surprisingly, we have found that simple postural changes before or during measurement lead to significant fluid shifts in the lower leg that are as important and as long lasting as the effects of haemodialysis...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28178704/the-influence-of-renal-centre-and-patient-sociodemographic-factors-on-home-haemodialysis-prevalence-in-the-uk
#20
Anuradha Jayanti, Philip Foden, Alasdair Rae, Julie Morris, Paul Brenchley, Sandip Mitra
BACKGROUND: In the United Kingdom, socioeconomic disadvantage has been associated with lower use of home dialysis, mostly peritoneal dialysis. In this study, we explore the role of a patient's sociodemographic, socioeconomic differences and the centre's influence on home haemodialysis (HD) prevalence. METHODS: Data is derived from the cross-sectional arm of the UK multi-centre study investigating barriers and enablers of home HD (BASIC-HHD study). Centres were classified as low- (<3%), medium- (5-8%) and high-prevalence groups (>8%)...
2017: Nephron
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