BACKGROUND: Home dialysis is a cost-effective renal replacement strategy, which provides improved quality of life compared to conventional in-center hemodialysis (CHD). To date, most studies support the use of multidisciplinary chronic kidney disease (CKD) clinics to facilitate timely initiation of dialysis. This is an observational cohort study examining 486 patients with CKD over the period of 2001-2007 to ascertain potential demographic differences among patients transitioned to in-center versus home dialysis. SUBJECTS AND METHODS: From January 2001 to December 2007, 486 patients with CKD attended the multidisciplinary renal management clinic at the University Health Network in Toronto. RESULTS: One hundred and fifty-three of the 486 patients were initiated on renal replacement therapy [59 to center hemodialysis (CHD), 15 to home hemodialysis (HHD) and 79 to home peritoneal dialysis (PD)]. HHD patients were younger (48 ± 15 years) than those who selected CHD (62 ± 16 years) or PD (64 ± 16 years). Although the gender distribution was similar overall, the percentage of single males was higher in CHD versus home dialysis patients (29 vs. 15%, P < 0.05). There were no significant differences in other demographic, clinical and biochemical parameters at the time of dialysis initiation. Disinterest in home dialysis by patients and their families (25.4%) and lack of social support (12.1%) constituted the main barriers to home dialysis. Medical contraindications for home dialysis were present among 11% of the patients. Other less frequent barriers were inadequate space, communication barrier and inability to perform their own dialysis. CONCLUSIONS: Sixty-one percent of patients requiring dialysis chose a home dialysis modality. Patients' and their families' disinterest in home dialysis and lack of support (either perceived or actual) represented the major overall barriers to adoption of home dialysis.
BACKGROUND: Home dialysis is a cost-effective renal replacement strategy, which provides improved quality of life compared to conventional in-center hemodialysis (CHD). To date, most studies support the use of multidisciplinary chronic kidney disease (CKD) clinics to facilitate timely initiation of dialysis. This is an observational cohort study examining 486 patients with CKD over the period of 2001-2007 to ascertain potential demographic differences among patients transitioned to in-center versus home dialysis. SUBJECTS AND METHODS: From January 2001 to December 2007, 486 patients with CKD attended the multidisciplinary renal management clinic at the University Health Network in Toronto. RESULTS: One hundred and fifty-three of the 486 patients were initiated on renal replacement therapy [59 to center hemodialysis (CHD), 15 to home hemodialysis (HHD) and 79 to home peritoneal dialysis (PD)]. HHDpatients were younger (48 ± 15 years) than those who selected CHD (62 ± 16 years) or PD (64 ± 16 years). Although the gender distribution was similar overall, the percentage of single males was higher in CHD versus home dialysispatients (29 vs. 15%, P < 0.05). There were no significant differences in other demographic, clinical and biochemical parameters at the time of dialysis initiation. Disinterest in home dialysis by patients and their families (25.4%) and lack of social support (12.1%) constituted the main barriers to home dialysis. Medical contraindications for home dialysis were present among 11% of the patients. Other less frequent barriers were inadequate space, communication barrier and inability to perform their own dialysis. CONCLUSIONS: Sixty-one percent of patients requiring dialysis chose a home dialysis modality. Patients' and their families' disinterest in home dialysis and lack of support (either perceived or actual) represented the major overall barriers to adoption of home dialysis.
Authors: Jeannette G Van Manen; Johanna C Korevaar; Friedo W Dekker; Elisabeth W Boeschoten; Patrick M M Bossuyt; Raymond T Krediet Journal: J Am Soc Nephrol Date: 2003-02 Impact factor: 10.121
Authors: Kitty J Jager; Johanna C Korevaar; Friedo W Dekker; Raymond T Krediet; Elisabeth W Boeschoten Journal: Am J Kidney Dis Date: 2004-05 Impact factor: 8.860
Authors: David C Mendelssohn; Salim K Mujais; Steven D Soroka; John Brouillette; Tomoko Takano; Paul E Barre; Bharati V Mittal; Ajay Singh; Catherine Firanek; Ken Story; Fredric O Finkelstein Journal: Nephrol Dial Transplant Date: 2008-08-28 Impact factor: 5.992
Authors: Paul M Just; Frank Th de Charro; Elizabeth A Tschosik; Les L Noe; Samir K Bhattacharyya; Miguel C Riella Journal: Nephrol Dial Transplant Date: 2008-01-30 Impact factor: 5.992
Authors: Bessie A Young; Christopher Chan; Christopher Blagg; Robert Lockridge; Thomas Golper; Fred Finkelstein; Rachel Shaffer; Rajnish Mehrotra Journal: Clin J Am Soc Nephrol Date: 2012-10-04 Impact factor: 8.237
Authors: Matthew Phillips; Colleen Wile; Carolyn Bartol; Cynthia Stockman; Minakshi Dhir; Steven D Soroka; Jay Hingwala; Joanne M Bargman; Christopher T Chan; Karthik K Tennankore Journal: Can J Kidney Health Dis Date: 2015-04-28
Authors: Karthik K Tennankore; Jay Hingwala; Diane Watson; Joanne M Bargman; Christopher T Chan Journal: BMC Nephrol Date: 2013-09-10 Impact factor: 2.388
Authors: Jenna M Evans; Sarah M Wheeler; Saurabh Sati; Sharon Gradin; Marnie MacKinnon; Peter G Blake Journal: Int J Integr Care Date: 2021-06-22 Impact factor: 5.120