Abstract: SA-PO679

Use of an NxStage Machine at Home for Vegetative, Disabled, and Home Bound Dialysis Patients: A Preliminary Result of a Unique Experience

Session Information

Category: Dialysis

  • 604 Home and Frequent Dialysis

Authors

  • Bernieh, Bassam O., The Heart Medical Center, Al Ain-Abu Dhabi, United Arab Emirates
  • Calaud, Fredric, Al Ain Life, Abu Dhabi, United Arab Emirates
  • Ahmed, Musa, Al Ain Life, Abu Dhabi, United Arab Emirates
  • Hernandez, Bienmelyn Lagasca, Al Ain Life, Abu Dhabi, United Arab Emirates
Background

Home hemodialysis (HHD) was invented to treat active, autonomous, and relatively, healthy dialysis patients. The number of dialysis patients, who are vegetative, debilitated, bed and home bound is steadily increasing, creating a major burden on the health care system. We are presenting our new and unique experience of treating these highly co-morbid and disabled dialysis patients, with nursing assisted home hemodialysis (NAHHD). The purpose of this modality is to decrease risks, financial , and emotional burdens, of the patients, their families, and of the health care providers.

Methods

Hemodialysis patients who were fulfilling the National Insurance Company criteria for HHD were accepted in the NAHHD program. These criteria include mainly bed and home bound patients. NxStage System One is used to deliver the hemodialysis at home or at long term care facility with a hemodialysis nurse. Duration of session, weekly number of session and volume of fluid are calculated by dose calculator given by NxStage Company, with a target standardized KT/V of 2.

Results


Nineteen dialysis patients on NxStage machine at home or in a long term care facility were included in this preliminary study. 7(36.8%) males and 12 (63.2%) females. Median age 73 year (42-88). Median duration on NAHHD was 3 months (2-8). Etiology of end stage renal disease was DM 13(68.5%), HTN 5 (26.5%), and familial nephropathy 1(5%). Indications of NAHHD were: vegetative status 1, bed and home bound 17, and 1 HIV case. Vascular access: AVF 8 (42%), AVG 1(5%), and tunneled catheter 10(53%).Average dialysate volume was 25 L. Number of session per week was 4, and average duration of session 3:10 hours. Pre-dialysis BP 131.2±30.5/66±9.3, post dialysis BP 136.6±36.7/ 64.4±5 (p=NS).). The average of the standardized KT/V was 1.94.There was a positive impact of the NAHHD on the patients’ quality of life, as measured by time of recovery of 13.75 minutes, average sleeping of 6 hours, and satisfaction of 7.5/10.

Conclusion

NAHHD by using NxStage machine is a very promising modality for treating vegetative, debilitated, bed and home bound dialysis patients, providing a good quality of care, managing the sufferance of the patients, and of their families, and decreasing the risks and the cost of special transportation.