Abstract: SA-PO470
A Single-Centre Experience with Assisted Home Hemodialysis in Long-Term Care Facilities
Session Information
- Home Dialysis - 2
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Ashley, Justin Marc, Humber River Health, Toronto, Ontario, Canada
- Joseph, Shayne Kallukalam, McMaster University, Hamilton, Ontario, Canada
- Hamidi, Shabnam, Humber River Health, Toronto, Ontario, Canada
- Nesrallah, Gihad, Humber River Health, Toronto, Ontario, Canada
- Lam, Danica, Humber River Health, Toronto, Ontario, Canada
- Mendelssohn, David C., Humber River Health, Toronto, Ontario, Canada
Background
To address challenges imposed by the COVID-19 pandemic, our renal program expanded assisted home hemodialysis (HD) services to provide on-site HD to patients residing in long-term care (LTC) facilities.
The purpose of this study was to describe the patient and treatment characteristics and outcomes in a cohort of patients undergoing home HD in LTC facilities.
Methods
We conducted a retrospective review of all consecutive patients across 15 LTC facilities within our catchment area in Toronto who converted from in-centre HD to LTC-HD between March 2020 and March 31, 2023. We included all adult patients who received assisted conventional (3 HD/week, 3-4 hr) and short-daily (5-7 HD/week, 2-3 hr) HD provided by a registered nurse, registered practical nurse, or personal support worker during the study period. We extracted all data from our hospital electronic record system, including baseline demographics, comorbidities, dialysis prescriptions, deaths, hospitalizations, COVID-19 related and unrelated infections.
Results
The mean age among 44 eligible patients was 75.6 years with 30 (70%) male patients and 13 (30%) female patients. Thirty-one (67%) patients had type two diabetes. There were 20 patients (45%) on conventional HD and 24 patients (54%) on daily HD at the time of enrolment. Eighty-five percent had limited mobility or were bedbound and 33% had dementia. During follow-up, there were 23 deaths with a one-year mortality rate of 45%. There were 69 hospitalization events, including 13 intensive care unit (ICU) admissions, with an average length of stay of 11 days. The number of access related complications was 18. There were 10 COVID-19 infections.
Conclusion
Assisted hemodialysis in LTC facilities is a patient-centered means by which to provide dialysis to a frail and vulnerable patient population. As expected, clinical outcomes were relatively poor. Additional analyses with control data as well as costing and ethical evaluations are ongoing and will be reported separately.