Abstract: SA-PO918
Nurse Assisted Home Hemodialysis (NAHHD) by Using NxStage Cycler for Home Bound, And Multi-Comorbid Hemodialysis Patients: One Year Experience
Session Information
- Dialysis: Home Hemodialysis
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 702 Dialysis: Home Hemodialysis
Authors
- Bernieh, Bassam O., HHD for Home Health Care, Al Ain-Abu Dhabi, United Arab Emirates
- Calaud, Fredric, HHD for Home Health Care, Al Ain-Abu Dhabi, United Arab Emirates
Background
Home hemodialysis (HHD) is used to treat active, HD patients. The steady increase in the number of HD patients, with multi comorbidities, and bed bound, is creating a significant burden on the active hospital beds. We are presenting our one year experience of treating those highly comorbid HD patients, with (NAHHD), at home or in long term care facilities.
Methods
HD patients who were fulfilling criteria for HHD were accepted in the NAHHD program. NxStage System One is used to deliver HD therapy at home or at long term care, by an experienced HD nurse. Dialysate volume, length, and weekly number of the HD sessions, were calculated by a calculator given by NxStage Company, targeting weekly standardized KT/V≥ 2. Only patients who were at least for three months and those who completed one year in the (NAHHD) program were included in the study.
Results
Forty seven dialysis patients on NAHHD were included in this study. Eighteen males (38%), and 29 females (62%). Mean age 69.2±17.7 year. Mean duration on NAHHD was 12 months. Etiology of end stage renal disease was DM 35(74%), HTN 10 (21%), and others 2(5%). Average number of comorbidities 9.3±3(6–16). Indications of NAHHD were: bed bound 27 (57%), morbid obesity 9(19%), psychiatric disorders, mental retardation 7(15%), and others 4(9%).Vascular access: AVF 23 (49%), AVG 2(5%), and tunneled catheter 22 (46%). Average dialysate volume was 25 L. Number of weekly session was 4, and average duration of session 3.3 hours. All patients tolerated well their dialysis sessions. The average weekly standardized KT/V was 2. There were 7 line sepsis, with an incidence of 0.6 episode/ 1000 catheter days. There was 56 hospital admissions (1.2 admission/patient/year), with average hospital stay of 7.4 days. The annual mortality rate of the total cohort was 17.7%. There was a positive impact of the NAHHD on the patients’ quality of life, as measured by time of recovery of 21 minutes, average sleeping of 6.5 hours, good appetite in 81%, along with patients and families satisfaction of 80%.
Conclusion
The results of one year experience of NAHHD by using NxStage machine in bed, home bound, and multi comorbid, HD patients, confirmed its efficacy, good quality of care, and its safety. It has significant positive impact on the quality of life and satisfaction of both patients, and their families.