TY - JOUR
T1 - Key elements in selection of pre-dialysis patients for home dialysis
AU - Bonenkamp, Anna A
AU - Reijnders, Tom D Y
AU - der Sluijs, Anita van Eck van
AU - Hagen, E Christiaan
AU - Abrahams, Alferso C
AU - van Ittersum, Frans J
AU - van Jaarsveld, Brigit C
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: The conduct of the analyses was supported by funding from the Dutch Medical Specialists Quality Foundation (SKMS) and the Dutch Kidney Foundation.
Publisher Copyright:
© The Author(s) 2021.
PY - 2021/9
Y1 - 2021/9
N2 - BACKGROUND: Most pre-dialysis patients are medically eligible for home dialysis, and home dialysis has several advantages over incentre dialysis. However, accurately selecting patients for home dialysis appears to be difficult, since uptake of home dialysis remains low. The aim of this study was to investigate which medical or psychosocial elements contribute most to the selection of patients eligible for home dialysis.METHODS: All patients from a Dutch teaching hospital, who received treatment modality education and subsequently started dialysis treatment, were included. The pre-dialysis programme consisted of questionnaires for the patient, nephrologist and social worker, followed by an assessment of eligibility for home dialysis by a multidisciplinary team. Clinimetric assessment and logistic regression were used to identify domains and questions associated with home dialysis treatment.RESULTS: A total of 135 patients were included, of whom 40 were treated with home dialysis and 95 with incentre haemodialysis. The key elements associated with long-term home dialysis treatment were part of the domains 'suitability of the housing', 'self-care', 'social support' and 'patient capacity', with adjusted odds ratios ranging from 0.13 for negative to 18.3 for positive associations.CONCLUSION: The assessment of contraindications by a nephrologist followed by the assessment of possibilities by a social worker or dialysis nurse who investigates four key elements, ideally during a home visit, and subsequent detailed education offered by specialized nurses is an optimal way to select patients for home dialysis.
AB - BACKGROUND: Most pre-dialysis patients are medically eligible for home dialysis, and home dialysis has several advantages over incentre dialysis. However, accurately selecting patients for home dialysis appears to be difficult, since uptake of home dialysis remains low. The aim of this study was to investigate which medical or psychosocial elements contribute most to the selection of patients eligible for home dialysis.METHODS: All patients from a Dutch teaching hospital, who received treatment modality education and subsequently started dialysis treatment, were included. The pre-dialysis programme consisted of questionnaires for the patient, nephrologist and social worker, followed by an assessment of eligibility for home dialysis by a multidisciplinary team. Clinimetric assessment and logistic regression were used to identify domains and questions associated with home dialysis treatment.RESULTS: A total of 135 patients were included, of whom 40 were treated with home dialysis and 95 with incentre haemodialysis. The key elements associated with long-term home dialysis treatment were part of the domains 'suitability of the housing', 'self-care', 'social support' and 'patient capacity', with adjusted odds ratios ranging from 0.13 for negative to 18.3 for positive associations.CONCLUSION: The assessment of contraindications by a nephrologist followed by the assessment of possibilities by a social worker or dialysis nurse who investigates four key elements, ideally during a home visit, and subsequent detailed education offered by specialized nurses is an optimal way to select patients for home dialysis.
KW - Home dialysis
KW - modality selection
KW - pre-dialysis programme
KW - social worker
KW - treatment modality education
UR - http://www.scopus.com/inward/record.url?scp=85113113382&partnerID=8YFLogxK
U2 - 10.1177/08968608211023263
DO - 10.1177/08968608211023263
M3 - Article
C2 - 34219552
SN - 0896-8608
VL - 41
SP - 494
EP - 501
JO - Peritoneal Dialysis International
JF - Peritoneal Dialysis International
IS - 5
ER -