Programmatic variation in home hemodialysis in Canada: results from a nationwide survey of practice patterns

Canadian Journal of Kidney Health and Disease
Robert P PaulyDeborah Lynn Zimmerman

Abstract

Over 40% of patients with end stage renal disease in the United States were treated with home hemodialysis (HHD) in the early 1970's. However, this number declined rapidly over the ensuing decades so that the overwhelming majority of patients were treated in-centre 3 times per week on a 3-4 hour schedule. Poor outcomes for patients treated in this fashion led to a renewed interest in home hemodialysis, with more intensive dialysis schedules including short daily (SDHD) and nocturnal (NHD). The relative infancy of these treatment schedules means that there is a paucity of data on 'how to do it'. We undertook a systematic survey of home hemodialysis programs in Canada to describe current practice patterns. Development and deployment of a qualitative survey instrument. Community and academic HHD programs in Canada. Physicians, nurses and technologists. Programmatic approaches to patient selection, delivery of dialysis, human resources available, and follow up. We developed the survey instrument in three phases. A focus group of Canadian nephrologists with expertise in NHD or SDHD discussed the scope the study and wrote questions on 11 domains. Three nephrologists familiar with all aspects of HHD delivery reviewed this for content ...Continue Reading

References

Dec 20, 2002·The New England Journal of Medicine·Garabed EknoyanUNKNOWN Hemodialysis (HEMO) Study Group
Mar 6, 2007·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Christopher R Blagg
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Sep 20, 2007·JAMA : the Journal of the American Medical Association·Bruce F CulletonBraden J Manns
Nov 10, 2007·Seminars in Dialysis·Robert P Pauly, Christopher T Chan
Mar 12, 2008·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Paul KomendaAdeera Levin
Jul 9, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Robert P PaulyChristopher T Chan
Jul 31, 2010·Clinical Journal of the American Society of Nephrology : CJASN·Robert P PaulyUNKNOWN CAN-SLEEP Collaborative Group
Nov 26, 2010·The New England Journal of Medicine·Glenn M ChertowAlan S Kliger
Mar 19, 2011·Clinical Journal of the American Society of Nephrology : CJASN·Bertrand L JaberUNKNOWN FREEDOM Study Group
Mar 1, 2012·Journal of the American Society of Nephrology : JASN·Eric D WeinhandlAllan J Collins
Mar 1, 2012·Journal of the American Society of Nephrology : JASN·Gihad E NesrallahRita S Suri
Apr 10, 2013·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Gihad E NesrallahDeborah L Zimmerman
Jun 19, 2013·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Reem A MustafaGihad E Nesrallah
Sep 3, 2013·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Ben WongRobert P Pauly

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Citations

Dec 3, 2014·Seminars in Dialysis·Mark R MarshallRobert P Pauly
Jul 26, 2017·Clinical Journal of the American Society of Nephrology : CJASN·Nikhil ShahRobert P Pauly
May 18, 2016·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·G Nesrallah
Jul 26, 2017·Clinical Journal of the American Society of Nephrology : CJASN·Jeffrey PerlChristopher T Chan
Nov 14, 2020·Clinical Journal of the American Society of Nephrology : CJASN·Robert P Pauly, Brent W Miller

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