A NEW PARADIGM: HOME THERAPY FOR PATIENTS WHO START DIALYSIS IN AN UNPLANNED WAY. Issue 1 (7th March 2013)

• Record Type: Journal Article
• Authors: Lecouf, Angelique; Ryckelynck, Jean‐Philippe; Ficheux, Maxence; Henri, Patrick; Lobbedez, Thierry
• Is Part Of: Journal of renal care. Volume 39:Issue 1(2013:Mar.)
• Page Start: 50
• Page End: 55
• Publication Date: 2013-03-07
• Subjects: Kidneys -- Diseases -- Nursing -- Periodicals; Hemodialysis -- Periodicals; Kidney Diseases -- nursing -- Periodicals; Renal Replacement Therapy -- nursing -- Periodicals; 616.61
• DOI: 10.1111/j.1755-6686.2013.00336.x
• Languages: English
• ISSNs: 1755-6678

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>SUMMARY</title> <sec id="jorc336-sec-0001" sec-type="section"> <title>Background</title> <p>Starting dialysis in a non‐planned manner or in a 'suboptimal' manner is a frequent situation in dialysis centres, even for patients with a regular nephrology follow‐up. Unplanned dialysis initiation can be defined as a patient beginning dialysis with no functional vascular access or peritoneal dialysis catheter. These patients start haemodialysis with a temporary catheter, frequently converted to a tunnelled catheter pending native fistula creation or whilst waiting for fistula maturation. In this case, conventional in‐centre haemodialysis (ICH) is more frequently used than peritoneal dialysis (PD) or home haemodialysis (HHD).</p> </sec> <sec id="jorc336-sec-0002" sec-type="section"> <title>Review findings</title> <p>This review found that patients who start dialysis in an unplanned way are significantly older and have more heart and peripheral vascular diseases. Home‐based dialysis therapies showed better outcomes than ICH (PD for the first two to three years and HHD for the long‐term).</p> </sec> <sec id="jorc336-sec-0003" sec-type="section"> <title>Recommendations</title> <p>This review proposes a paradigm shift in the initial form of dialysis offered to new patients starting dialysis in an unplanned way. Even if they require a temporary catheter, it is possible for them to receive a pre‐dialysis education programme (PDEP). The PDEP should be based on both individualised information session(s) given by an experienced nurse to the patient and family and therapeutic education (educative diagnosis, individualised and group session(s)) in order to relieve anxiety and promote home modalities.</p> </sec> </abstract>