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学科主题: 临床医学
题名:
Dialysis modality choices among chronic kidney disease patients: identifying the gaps to support patients on home-based therapies
作者: Zhang, Ai-Hua2,3; Bargman, Joanne M.3; Lok, Charmaine E.3; Porter, Eveline3; Mendez, Maria3; Oreopoulos, Dimitrios G.3; Chan, Christopher T.1,3
关键词: Dialysis modality selection ; Chronic kidney disease ; Home dialysis ; Social support
刊名: INTERNATIONAL UROLOGY AND NEPHROLOGY
发表日期: 2010-09-01
DOI: 10.1007/s11255-010-9793-9
卷: 42, 期:3, 页:759-764
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Urology & Nephrology
研究领域[WOS]: Urology & Nephrology
关键词[WOS]: RENAL REPLACEMENT THERAPY ; PERITONEAL-DIALYSIS ; ESRD PATIENTS ; SELECTION ; CARE ; NEPHROLOGISTS ; HEMODIALYSIS ; COMORBIDITY ; PROGRAMS
英文摘要:

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.

语种: 英语
WOS记录号: WOS:000284910500031
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/52252
Appears in Collections:北京大学第三临床医学院_肾内科_期刊论文

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作者单位: 1.Toronto Gen Hosp, Toronto, ON M5G 2C4, Canada
2.Univ Hlth Network, Div Nephrol, Toronto, ON, Canada
3.Peking Univ, Hosp 3, Div Nephrol, Beijing 100871, Peoples R China

Recommended Citation:
Zhang, Ai-Hua,Bargman, Joanne M.,Lok, Charmaine E.,et al. Dialysis modality choices among chronic kidney disease patients: identifying the gaps to support patients on home-based therapies[J]. INTERNATIONAL UROLOGY AND NEPHROLOGY,2010,42(3):759-764.
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