Home Hemodialysis: Patient Outcomes During a 24-Year Period of Time From 1970 Through 1993

Mailloux, Lionel U.; Kapikian, Nancy; Napolitano, Barbara; Mossey, Robert T.; Bellucci, Alessandro; Wilkes, Barry M.; Vernace, Melchiore A.; Miller, Ilene

doi:10.1016/s1073-4449(96)80050-1

Cited by 43 publications

(42 citation statements)

References 15 publications

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“…In addition, the therapy is versatile: It can be offered thrice weekly, as short daily session ($4 days per week), or nocturnally ($3 nights per week). Observational data suggest that home therapies may improve patient survival and quality of life and reduce uremic complications compared with thrice-weekly in-center HD (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Herein, we review barriers to home HD and provide strategies to build a successful home HD program.…”

Section: Introductionmentioning

confidence: 99%

How to Overcome Barriers and Establish a Successful Home HD Program

Young

Chan

Blagg

et al. 2012

Clinical Journal of the American Society of Nephrology

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Summary Home hemodialysis (HD) is an underused dialysis modality in the United States, even though it provides an efficient and probably cost-effective way to provide more frequent or longer dialysis. With the advent of newer home HD systems that are easier for patients to learn, use, and maintain, patient and provider interest in home HD is increasing. Although barriers for providers are similar to those for peritoneal dialysis, home HD requires more extensive patient training, nursing education, and infrastructure support in order to maintain a successful program. In addition, because many physicians and patients do not have experience with home HD, reluctance to start home HD programs is widespread. This in-depth review describes barriers to home HD, focusing on patients, individual physicians and practices, and dialysis facilities, and offers suggestions for how to overcome these barriers and establish a successful home HD program.

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Section: Introductionmentioning

confidence: 99%

How to Overcome Barriers and Establish a Successful Home HD Program

Young

Chan

Blagg

et al. 2012

Clinical Journal of the American Society of Nephrology

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“…Of these six studies, two compared home with satellite unit haemodialysis, 16,28 while four compared home with hospital haemodialysis. 18,24,32,33 The Cox model is a regression technique that can be used to statistically adjust for differences in baseline characteristics between groups that are being compared. As with other survival techniques such as the Kaplan-Meier procedure, it allows for censoring of survival times due to withdrawal or transfer to another therapy.…”

mentioning

confidence: 99%

“…Two studies gave details of adverse events, 15,31 including hypotension, vomiting, cramps, arrhythmia and headaches. Nine studies provided information on mortality/survival, 11,16,18,22,24,26,28,32,33 including median survival times and survival rates at 1, 5, 10 and 20 years.Sociodemographic characteristics and comorbidities were not evenly balanced between the participant groups, thereby potentially confounding the results. Six studies with survival as an outcome attempted to adjust for this imbalance by using the Cox proportional hazards regression model.…”

mentioning

confidence: 99%

“…Six studies with survival as an outcome attempted to adjust for this imbalance by using the Cox proportional hazards regression model. 16,18,24,28,32,33 The risk factors that the six studies included in their Cox models appeared to be appropriate, for example, age at the start of treatment, presence of diabetes, causes of ESRD and co-morbidities, although not all studies included these factors to the same extent. However, none of the studies appeared to have incorporated co-variates associated with the process of treatment in their Cox models, for example, the duration and frequency of dialysis.…”

mentioning

confidence: 99%

“…An additional source of heterogeneity is that the indications for home haemodialysis may have altered over the period during which the included studies were published. A meta-analysis was not undertaken, in order to avoid generating a spuriously precise overall estimate of effect around results that might be potentially biased.Although a number of studies gave details of the distribution of co-morbidities between the participant groups, [17][18][19]21,22,24,28,31,33,36 in no study were all co-morbidities approximately balanced between groups. Generally, the percentage of home haemodialysis participants with specific co-morbidities was lower than the percentage of people in the hospital/satellite unit group with those co-morbidities, introducing further potential for confounding.…”

mentioning

confidence: 99%

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Systematic review of the effectiveness and cost-effectiveness, and economic evaluation, of home versus hospital or satellite unit haemodialysis for people with end-stage renal failure

Mowatt

Vale

Perez

et al. 2003

Health Technol Assess

167

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