Daily Home Hemodialysis Is an Available Option for Renal Replacement Therapy in Spain

Vega, Almudena; Sequí, María José; Abad, Soraya; Yuste, Claudia; Santos, Alba; Macías, Nicolás; López‐Gómez, Juan M.

doi:10.1111/1744-9987.12400

Cited by 5 publications

(5 citation statements)

References 17 publications

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“…Xu et al found no obvious changes of BUN [15] and Epo in either groups after sodium ferrous chlorophyll treatment of hemodialysis patients; whereas, Epo dosage was decreased more significantly than in the control group (P < 0.05). Vega et al found the mean equivalent renal urea clearance at [16] 15.6 ± 4.2 mL/min and the Epo resistance index at 3.7 ± 2.1 IU/kg/week/g/dL in patients who received home hemodialysis. Ibrahim et al [17] exhibited reduced serum levels of Epo and increases in the kidney function markers (urea and creatinine) in male Wistar rats of induced diabetes mellitus than control ones.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Hypazotemic Effects of Erythropoietin and U-74389G on Urea Levels

Tsompos¹,

Panoulis²,

Toutouzas³

et al. 2018

Clinic Res Urol

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The hypoxia-reoxygenation (HR) type of experiments was noted in 4.29% of these studies. A tissue-protective feature of U-74389G was obvious in these HR studies. The U-74389G chemically known as 21-[4-(2,6-di-1-pyrrolidinyl-4pyrimidinyl)-1-piperazinyl]-pregna-1,4,9(11)-triene-3,20dione maleate salt is an antioxidant complex, which prevents the lipid peroxidation either iron-dependent or arachidonic acid-induced one. Animal kidney, liver, brain microvascular endothelial cells monolayers, and heart models were protected by U-74389G after HR injury. U-74389G also attenuates the leukocytes, downregulates the proinflammatory gene, treats the endotoxin shock, produces cytokine, enhances the mononuclear immunity, protects the endothelium, and presents antishock property. Erythropoietin (Epo) even whether is not famous for its hypazotemic action (P = 0.4430), it can be used as a reference

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Section: Discussionmentioning

confidence: 99%

Comparison of the Hypazotemic Effects of Erythropoietin and U-74389G on Urea Levels

Tsompos¹,

Panoulis²,

Toutouzas³

et al. 2018

Clinic Res Urol

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“…Para ello, es fundamental que los propios profesionales sanitarios implicados en la comunicación/divulgación de la HDD crean en ella. La supervivencia de los pacientes que se dializan en HDD intensiva o diaria, es otro de los factores dignos de resaltar 45 . Frente a otras modalidades como son la HD en el centro o la diálisis peritoneal, la HDD diaria o intensiva presenta mejores resultados, si bien las series publicadas son pequeñas respecto a las de las otras modalidades.…”

Section: Discussionunclassified

Estado actual de la utilización de la hemodiálisis domiciliaria: revisión integrativa

2018

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Objetivo: Conocer la producción científica existente sobre el estado actual de la hemodiálisis domiciliaria. Material y Método: Se ha realizado una revisión integrativa mediante una búsqueda en las bases de datos Pubmed, Scopus y Google Académico. Se incluyeron artículos científicos originales y de revisión, en inglés y español, excluyendo aquellos artículos que no presentaban resultados o que no estuviesen en texto completo. Resultados: Se han incluido 23 artículos publicados entre el año 2012 y 2017. La hemodiálisis domiciliaria es poco utilizada en el mundo, a excepción de Australia y Nueva Zelanda. Las series publicadas encuentran mejor supervivencia en los pacientes en hemodiálisis domiciliaria diaria o intensiva, respecto a otras modalidades de terapia sustitutiva renal, así como mejores resultados clínicos. Como principales ventajas de la técnica, se destaca la flexibilidad en la vida diaria y la independencia del centro sanitario. Como principal inconveniente se ha encontrado un aumento de las infecciones relacionadas con el uso de catéteres venosos centrales o la técnica de punción en “ojal”. Conclusiones: La hemodiálisis domiciliaria presenta como principal ventaja la mayor libertad y flexibilidad para que el paciente dirija su propio tratamiento, siendo el principal inconveniente, una mayor probabilidad de padecer infecciones, relacionadas con el acceso vascular. Cuando se realiza hemodiálisis domiciliaria diaria o intensiva los resultados clínicos se muestran superiores a los otros procedimientos de diálisis, siendo comparables a los del trasplante renal. El papel de enfermería es fundamental en el desarrollo de esta técnica, especialmente en el proceso clave de la enseñanza al paciente y familiar.

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“…The failure of early dialysis to prolong life and improve its quality has caused nephrologists to reflect on the negative effects of treatment [7,115,116,117,118,119,120]. This was also the starting point for reconsidering incremental dialysis and for realizing that, especially in elderly patients, the advantages of a high dialysis dose are often counterbalanced by the iatrogenicity of treatment [120,121,122,123,124,125]. Increasing the dialysis dose by increasing the number (and/or duration) of sessions may, conversely, be necessary in particular situations, such as pregnancy or high metabolic needs, or be a suitable way to attain tolerance in fragile individuals [49,50,51,52,53,125,126,127].…”

Section: One-size-fits-all or Tailor-made Treatments?mentioning

confidence: 99%

Dialysis Reimbursement: What Impact Do Different Models Have on Clinical Choices?

Piccoli

Cabiddu

Breuer

et al. 2019

JCM

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Allowing patients to live for decades without the function of a vital organ is a medical miracle, but one that is not without cost both in terms of morbidity and quality of life and in economic terms. Renal replacement therapy (RRT) consumes between 2% and 5% of the overall health care expenditure in countries where dialysis is available without restrictions. While transplantation is the preferred treatment in patients without contraindications, old age and comorbidity limit its indications, and low organ availability may result in long waiting times. As a consequence, 30–70% of the patients depend on dialysis, which remains the main determinant of the cost of RRT. Costs of dialysis are differently defined, and its reimbursement follows different rules. There are three main ways of establishing dialysis reimbursement. The first involves dividing dialysis into a series of elements and reimbursing each one separately (dialysis itself, medications, drugs, transportation, hospitalisation, etc.). The second, known as the capitation system, consists of merging these elements in a per capita reimbursement, while the third, usually called the bundle system, entails identifying a core of procedures intrinsically linked to treatment (e.g., dialysis sessions, tests, intradialyitc drugs). Each one has advantages and drawbacks, and impacts differently on the organization and delivery of care: payment per session may favour fragmentation and make a global appraisal difficult; a correct capitation system needs a careful correction for comorbidity, and may exacerbate competition between public and private settings, the latter aiming at selecting the least complex cases; a bundle system, in which the main elements linked to the dialysis sessions are considered together, may be a good compromise but risks penalising complex patients, and requires a rapid adaptation to treatment changes. Retarding dialysis is a clinical and economical goal, but the incentives for predialysis care are not established and its development may be unfavourable for the provider. A closer cooperation between policymakers, economists and nephrologists is needed to ensure a high quality of dialysis care.

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Daily Home Hemodialysis Is an Available Option for Renal Replacement Therapy in Spain

Cited by 5 publications

References 17 publications

Comparison of the Hypazotemic Effects of Erythropoietin and U-74389G on Urea Levels

Comparison of the Hypazotemic Effects of Erythropoietin and U-74389G on Urea Levels

Estado actual de la utilización de la hemodiálisis domiciliaria: revisión integrativa

Dialysis Reimbursement: What Impact Do Different Models Have on Clinical Choices?

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