Home dialysis and Covid-19 in french speaking countries (RDPLF data-base)

Aims of the study: to assess the frequency of symptomatic Covid-19 in home dialysis patients and its influence on the number of patients treated at home in dialysis units of centers included in the French-speaking peritoneal and home hemodialysis Registry (RDPLF). Focus is placed on patients treated by peritoneal dialysis (PD) in mainland France. Results: in home hemodialysis (HHD)the incidence is 6% in Belgium and 4.8% in mainland France. On peritoneal dialysis it is 10.6% in Belgium, 6.7% in mainland France, 10.8% in Morocco and 11.5% in Tunisia. Lethality is less than 5% in HHD and between 8.4% and 42.7% in PD depending on age and associated comorbidities. In France, the percentage of patients who have had symptomatic Covid-19 is lower on home dialysis, all methods combined. Nevertheless, among the home methods, the higher frequencies and severities are observed in mainland France in home assisted PD: these are the oldest and most co-morbid patients. Transfers from PD to in center hemodialysis have increased during Covid-19 pandemic while the number of transplants has decreased. Conclusion: if the drop in the number of transplants can be explained by a reduced availability of operating theaters and surgical teams during a pandemic period, it is paradoxical that the prescription of home dialysis, which should be supposed to limit the risk of contagion, has decreased. More investigation should be performed to understand this paradox.

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HOME DIALYSIS DURING COVID-19 OUTBREAK– IT IS WORTH TO CONSIDER

Wiadomości Lekarskie ◽

10.36740/wlek202010141 ◽

2020 ◽

Vol 73 (10) ◽

pp. 2316-2318

Author(s):

Paweł Żebrowski ◽

Jacek Zawierucha ◽

Wojciech Marcinkowski ◽

Tomasz Prystacki ◽

Inga Chomicka ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Medical Personnel ◽

Medical Facility ◽

Immune Disorders ◽

Dialysis Patients ◽

Home Hemodialysis ◽

Home Dialysis ◽

Number Of Patients

The epidemic with the new SARS-CoV-2 virus poses a serious threat to patients treated with renal replacement therapy. Besides clinical risk factors (such as numerous comorbidities, immune disorders), dialysis patients are additionally exposed to the virus through regular stays for several hours in a dialysis center and ambulance journeys. In such an epidemiological situation, it seems that peritoneal dialysis and home hemodialysis are good alternatives for treatment. Currently available telemedicine and medical technologies allow for effective renal replacement therapy also outside dialysis centers. Thanks to this, it is possible to limit the stay of patients in a medical facility to clinically justified situations. For this reason, increasing the number of patients treated with peritoneal dialysis, which is carried out at home and without contact with medical personnel, seems to be a good solution. Enabling patients to undergo home hemodialysis treatment, nowadays unavailable in Poland and establishing it as a guaranteed benefit in the health care system will enable renal replacement therapy to be adapted to the clinical condition and the need for isolation.

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Comparison of Psychological Adjustment to Continuous Ambulatory Peritoneal Dialysis and Home Hemodialysis

Peritoneal Dialysis International ◽

10.1177/089686088100200209 ◽

1981 ◽

Vol 2 (2) ◽

pp. 82-84 ◽

Cited By ~ 2

Author(s):

Howard J. Burton ◽

Atara Kaplan De-Nour ◽

John A. Conley ◽

George A. Wells ◽

Lokky Wais

Keyword(s):

Peritoneal Dialysis ◽

Psychological Adjustment ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Sexual Satisfaction ◽

Dialysis Patients ◽

Home Hemodialysis ◽

Home Dialysis ◽

Household Members ◽

Demographic Background

Two groups of home dialysis patients (40 on CAPD and 37 on home hemo dialysis) matched for length of time on dialysis, and for demographic background were studied and compared. The CAPD patients were significantly more satisfied with the support received from household members and from spouses, more satisfied with the relations with spouses, more understood by them and more understanding of their spouses. Sexual satisfaction declined in both groups. However, sexual satisfaction was slightly higher in the CAPD group and these patients experienced slightly less difficulty in adjusting to the decline; none of these differences were statistically significant.

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Comparison of Psychological Adjustment to Continuous Ambulatory Peritoneal Dialysis and Home Hemodialysis

Peritoneal Dialysis International ◽

10.1177/089686088100200207 ◽

1981 ◽

Vol 2 (2) ◽

pp. 76-78 ◽

Cited By ~ 7

Author(s):

Howard J. Burton ◽

Atara Kaplan De-Nour ◽

John A. Conley ◽

George A. Wells ◽

Lokky Wais

Keyword(s):

Peritoneal Dialysis ◽

Psychological Adjustment ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Sexual Satisfaction ◽

Dialysis Patients ◽

Home Hemodialysis ◽

Home Dialysis ◽

Household Members ◽

Demographic Background

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Home dialysis in french speaking countries in 2020 (RDPLF database)

Bulletin de la Dialyse à Domicile ◽

10.25796/bdd.v4i1.61543 ◽

2021 ◽

Vol 4 (1) ◽

pp. 55-70

Author(s):

Christian Verger ◽

Ghislaine Veniez ◽

Marie-Christine Padernoz ◽

Emmanuel Fabre

Keyword(s):

Peritoneal Dialysis ◽

Clinical Symptoms ◽

Low Flow ◽

Central Catheter ◽

Dialysis Treatment ◽

Home Dialysis ◽

Daily Hemodialysis ◽

French Speaking ◽

Patient Profiles ◽

At Home

The RDPLF collects the main peritoneal dialysis data from centers in French-speaking countires and, since 2012, home hemodialysis (HHD) data. This article presents a summary of the main results in the RDPLF in 2020. It highlights important differences in the practices and patient profiles between French-speaking countries. Mortality in patients with clinical symptoms of COVID-19 varied from 15 to 63% depending on the country. A slight drop in the incidence rate for peritoneal dialysis in 2020 was observed when the Covid-19 pandemic should have favored a dialysis treatment at home. In patients with HHD, daily hemodialysis five days a week, at a low flow rate of dialysate, is predominant in the new centers and sometimes begins to appear as a mode of transition which allows to maintain at home patients who cannot anymore be treated by PD. In HHD, the use of a central catheter is frequent in Belgium while this is exceptional in France. Likewise, in France, puncture of an arteriovenous fistula remains classic, while in Belgium the Buttonhole technique is widely preferred. We did not observe COVID-19 mortality in HHD in 2020 but only 47% of HDD patients are included in the RDPLF while 98% of PD patients are included.

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Home dialysis : what are the barriers . A French nephrologist survey

Bulletin de la Dialyse à Domicile ◽

10.25796/bdd.v2i2.20463 ◽

2019 ◽

Vol 2 (2) ◽

pp. 47-53

Author(s):

Magalie Geneviève ◽

Stanislas Bataille ◽

Julie Beaume ◽

Aldjia Hocine ◽

Louis De Laforcade ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Life Quality ◽

Reporting Rate ◽

Third Party ◽

Regulatory Evolution ◽

Home Hemodialysis ◽

Home Dialysis ◽

Lack Of Information ◽

Geographical Regions

Home dialysis, which includes Peritoneal Dialysis and Home Hemodialysis, provides lots of profit to patients suffering of Chronic Kidney Disease, especially in terms of comfort, life quality and autonomy. However, its use is marginal in France, with an inhomogenous distributaion according to geographical regions. We conducted a French national survey of nephrologists to assess the barriers to the development of home dialysis. After analyzing the responses of the 230 participating nephrologists, the main obstacles to the development of the two techniques were identified and classified according to their reporting rate. The major obstacles that emerge from the survey are : the lack of information among the general public, a lack of acknowledgement of nurses specializing in these techniques, the limited number of structures that practice dialysis at home, and information difficulties among patient about dialysis techniques. The specific peritoneal dialysis-related difficulties reported are : difficulties in management of follow-up care and rehabilitation, the fear of insufficient purification and the difficulties related to the dialysis catheter. Concerning home hemodialysis, the barriers concern fear of autopunction and the need for a third party. This study helps to identify the representations of nephrologists on the major obstacles to the development of home dialysis to develop lines of thought for its promotion, both in terms of training, institutional acknowledgement, and the necessary regulatory evolution.

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Anemia in peritoneal dialysis patients

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0604133l ◽

2006 ◽

Vol 134 (3-4) ◽

pp. 133-137 ◽

Cited By ~ 1

Author(s):

Mirjana Lausevic ◽

Vidosava Nesic ◽

Natasa Jovanovic ◽

Biljana Stojimirovic

Keyword(s):

Peritoneal Dialysis ◽

Blood Count ◽

Iron Supplementation ◽

Transferrin Saturation ◽

Recombinant Erythropoietin ◽

Dialysis Patients ◽

Human Recombinant Erythropoietin ◽

Iron Stores ◽

Number Of Patients ◽

Significant Difference

A normocytic normochromic anemia is one of the first signs of renal failure. Since anemia increases morbidity and mortality, its elimination is one of the essential objectives of the treatment. Human recombinant erythropoietin (rHuEPO) has changed the therapeutical approach to anemia. The aim of the present study was to compare efficacy of anemia correction in peritoneal dialysis patients depending on treatment and dialysis modality. The study is the retrospective analysis of 64 patients who presented to our Clinic in 2003. Eighteen (28.13%) patients were treated with rHuEPO, 14 (28%) underwent continuous ambulatory peritoneal dialysis (CAPD), 2 (100%) - automated peritoneal dialysis (APD) and 2 (33.3%) - intermittent peritoneal dialysis (IPD). Mean hemoglobin level was 98.6?17.82 g/l in patients treated with rHuEPO versus 98.81?15.14 g/I in patients without rHuEPO treatment. Erythropoietin requirements were 3392.85?1211.77 IU/week. AII patients received iron supplementation during rHuEPO therapy. Mean serum ferritin levels were 463.41 ?360 ?g/l. Transferrin saturation (TSAT) was 0.35?0.16%. No difference of serum iron and TSAT levels was found between CAPD and IPD patients. The degree of anemia significantly differed between CAPD and IPD patients. A total of 17.11% of PD patients were given blood transfusions, most frequently during the first three months after the onset of dialysis. Our conclusion is that the number of patients receiving rHuEPO should be increased, as 50% of our patients should be substituted, while only 28% are being treated. As 50% of patients receiving rHuEPO failed to reach target Hgb levels, higher EPO doses should be considered. Iron stores should be continuously monitored, particularly in patients receiving rHuEPO, since iron deficiency is an important problem for patients undergoing peritoneal dialysis, especially during erythropoietin therapy. Oral iron supplementation is satisfactory in the majority of patients, and iron-gluconate is absorbed better than iron-sulphate. If required, intra-venous iron bolus is safe and efficient. Continuous peritoneal dialysis treatment improves blood count more effectively compared to intermittent procedures, as hemoglobin levels are significantly higher in patients with comparable iron stores. Peritoneal dialysis is particularly efficient in improving the blood count in diabetics, since no significant difference of anemia between patients affected by diabetes mellitus and the others could be found in our study.

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FC 117TIME TRENDS IN PROBABILITY OF STARTING HOME DIALYSIS OVER A 20 YEAR PERIOD: A DUTCH REGISTRY STUDY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab127.003 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Anna Bonenkamp ◽

Tiny Hoekstra ◽

Marc Hemmelder ◽

Anita Van Eck van der Sluijs ◽

Alferso C Abrahams ◽

...

Keyword(s):

Kidney Transplantation ◽

The Netherlands ◽

Risk Model ◽

The Elderly ◽

Dialysis Patients ◽

Dialysis Treatment ◽

Home Dialysis ◽

System Utilization ◽

Number Of Patients ◽

Kidney Transplantations

Abstract Background and Aims A growing number of patients suffers from End Stage Kidney Disease(ESKD), causing a logistical and economic burden to the healthcare system. Utilization of home dialysis is low in many countries worldwide, although home dialysis has several advantages including higher quality of life and possibly lower costs. The aim of this study is to explore time trends in the use of home dialysis in the Netherlands. Method Anonymized registry data from the Dutch Renal Registry (RENINE) were used for this study. All dialysis episodes of adult patients who started dialysis treatment between 1997 through 2016 in the Netherlands were included, including those who previously underwent kidney transplantation. Dialysis episodes shorter than 90 days were excluded. The probability of starting home dialysis between 1997 through 2016 was evaluated in time periods of 5 years, using logistic regression analysis. Home dialysis was defined as start with peritoneal dialysis or home haemodialysis, or transfer to either within 2 years after dialysis start. A logistic multilevel model was used to adjust for clustering at patient level. The cumulative incidence function of start of home dialysis in incident patients was estimated with a competing risk model with recovery of kidney function, kidney transplantations, and all-cause mortality as competing events. All analyses were stratified for age categories at dialysis start: 20-44 years, 45-64 years, 65-74 years and ≥75 years. Results A total of 33,340 dialysis episodes in 31,569 patients were evaluated. Between 1997 and 2016, mean age at start of dialysis treatment increased from 62.5±14.0 to 65.5±14.5 years in in-centre haemodialysis patients, whereas it increased from 51.9±15.1 to 62.5±14.6 years in home dialysis patients. In patients < 65 years, the probability of starting home dialysis was significantly lower during each 5-year period compared to the previous period, and kidney transplantation occurred more often. In patients ≥ 65 years, incidence of home dialysis remained constant, whereas mortality decreased. Conclusion In patients < 65 years, the overall probability of starting home dialysis declined consistently over the past 20 years. The age of home dialysis patients increased more rapidly than that of in-centre dialysis patients, implying that pre-dialysis education and organization of home dialysis must be adapted to the needs of the elderly patient. These developments have a significant impact on the organisation of home dialysis for patients with ESKD.

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Peritoneal Dialysis in the Pacific

Peritoneal Dialysis International ◽

10.1177/089686089601601s86 ◽

1996 ◽

Vol 16 (1_suppl) ◽

pp. 448-451 ◽

Cited By ~ 1

Author(s):

Margaret J. King

Keyword(s):

Peritoneal Dialysis ◽

Clinical Practice ◽

Medical Condition ◽

Tertiary Education ◽

Research Quality ◽

Exit Site Infection ◽

Home Dialysis ◽

The Pacific ◽

Number Of Patients ◽

Management Issues

Peritoneal dialysis (PD) in the Pacific is the predominant dialysis modality for home dialysis patients. Patient location, age, personal preference, and medical condition are all taken into consideration. However, with the steadily increasing number of patients on PD, financial constraints are now affecting the nurse-patient ratios. As a consequence, PD nurses are constantly seeking new and improved clinical practice regimes with which they can provide and maintain quality, cost-effective nursing care. To enable PD nurses to provide such care, they are now, more than ever, Involved in patient, professional, and management issues. These patient issues include, but are not limited to: the elderly, the diabetic, the indigenous patient, and their carers, peritonitis, exit-site infection, and adequate dialysis. Professional issues include the development of standards of clinical practice, nursing research, quality improvement, and tertiary education. Management issues are constantly encroaching into the clinical practice setting, therefore the PD nurse must now justify spending, develop strategic plans, and meet annual budgets. In conclusion, it can be seen that PD nurses in the Pacific are faced with similar patient-care, professional, and management issues as their counterparts throughout the world.

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Keeping Home Dialysis Patients at Home

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2016.01.006 ◽

2016 ◽

Vol 67 (4) ◽

pp. 542-544 ◽

Cited By ~ 2

Author(s):

Peter G. Kerr ◽

John W.M. Agar

Keyword(s):

Dialysis Patients ◽

Home Dialysis ◽

At Home

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Assisted peritoneal dialysis across Europe: Practice variation and factors associated with availability

Peritoneal Dialysis International ◽

10.1177/08968608211049882 ◽

2021 ◽

pp. 089686082110498

Author(s):

Anita van Eck van der Sluijs ◽

Brigit C van Jaarsveld ◽

Jennifer Allen ◽

Karmela Altabas ◽

Clémence Béchade ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Online Survey ◽

Healthcare Professionals ◽

Practice Variation ◽

Dialysis Patients ◽

Home Dialysis ◽

Factors Associated ◽

Western European ◽

End Stage ◽

Dedicated Team

Background: In Europe, the number of elderly end-stage kidney disease patients is increasing. Few of those patients receive peritoneal dialysis (PD), as many cannot perform PD autonomously. Assisted PD programmes are available in most European countries, but the percentage of patients receiving assisted PD varies considerably. Hence, we assessed which factors are associated with the availability of an assisted PD programme at a centre level and whether the availability of this programme is associated with proportion of home dialysis patients. Methods: An online survey was sent to healthcare professionals of European nephrology units. After selecting one respondent per centre, the associations were explored by χ 2 tests and (ordinal) logistic regression. Results: In total, 609 respondents completed the survey. Subsequently, 288 respondents from individual centres were identified; 58% worked in a centre with an assisted PD programme. Factors associated with availability of an assisted PD programme were Western European and Scandinavian countries (OR: 5.73; 95% CI: 3.07–10.68), non-academic centres (OR: 2.01; 95% CI: 1.09–3.72) and centres with a dedicated team for education (OR: 2.87; 95% CI: 1.35–6.11). Most Eastern & Central European respondents reported that the proportion of incident and prevalent home dialysis patients was <10% (72% and 63%), while 27% of Scandinavian respondents reported a proportion of >30% for both incident and prevalent home dialysis patients. Availability of an assisted PD programme was associated with a higher incidence (cumulative OR: 1.91; 95% CI: 1.21–3.01) and prevalence (cumulative OR: 2.81; 95% CI: 1.76–4.47) of patients on home dialysis. Conclusions: Assisted PD was more commonly offered among non-academic centres with a dedicated team for education across Europe, especially among Western European and Scandinavian countries where higher incidence and prevalence of home dialysis patients was reported.[Formula: see text]

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