Abstract: SA-PO1070
Provision of Outpatient Backup Dialysis in a Home Hemodialysis Unit
Session Information
- Home Hemodialysis
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 702 Dialysis: Home Hemodialysis
Authors
- Kennedy, Claire, Toronto General Hospital, Toronto, Ontario, Canada
- Auguste, Bourne L.A, Toronto General Hospital, Toronto, Ontario, Canada
- Girsberger, Michael Yannik, Toronto General Hospital, Toronto, Ontario, Canada
- Srithongkul, Thatsaphan, Toronto General Hospital, Toronto, Ontario, Canada
- Faratro, Rose, University Health Network, Toronto, Ontario, Canada
- Chan, Christopher T., Toronto General Hospital, Toronto, Ontario, Canada
Background
Patients doing home hemodialysis (HHD) require support from the parent unit when medical, dialysis-related and psychosocial issues arise at home. It is important that each HHD program makes provision for timely clinical assessment and back-up hemodialysis (HD), although this need has not been well quantified previously.
Methods
This was a retrospective, single-center cohort study of a HHD unit with an open-door policy in terms of clinical assessment and back-up HD during weekday office hours. Back-up HD in the incenter HD unit was organized for outpatient situations that arose outside of these hours. Emergency situations were directed to the emergency department (ED). The HHD unit electronic and paper medical records were reviewed for a twelve-month period. The uptake of outpatient back-up HD was established and reasons for this need were summarized.
Results
There were 104 to 107 prevalent patients in the HHD program during the twelve-month period. 79 outpatients attended for back-up HD (167 separate issues requiring 254 back-up HD sessions). Back-up dialysis was performed most commonly for medical reasons; followed by vascular access issues, technical issues, respite HD and post-operative/post-procedure HD (Figure). The majority of these issues necessitated one back-up HD session, facilitated in the HHD unit during weekday office hours. Respite HD for psychosocial reasons accounted for a small proportion of provided back-up HD.
Conclusion
One to two staffed dialysis stations were required each weekday for back-up HD in this HHD program of 100+ patients. Prompt access to clinical assessment and back-up HD in the parent HHD unit may relieve pressure on the incenter HD unit, ED and inpatient ward, and may facilitate ongoing HHD technique survival.
Figure: The number of separate events necessitating back-up outpatient HD that arose in a twelve-month period, and the number of back-up HHD sessions each issue required.