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Kidney Week

Abstract: TH-PO318

Assisted Home Hemodialysis: A Game-Changer for Patients and Providers

Session Information

  • Home Dialysis - I
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Hamad, Abdullah Ibrahim, Hamad General Hospital, Doha, Qatar
  • Mohamed, Mohamed, Hamad General Hospital, Doha, Qatar
  • Elshirbeny, Mostafa, Hamad General Hospital, Doha, Qatar
  • Filali, Mossab, Hamad General Hospital, Doha, Qatar
  • Alkhayyat, Dina Nabeel, Hamad General Hospital, Doha, Qatar
  • Abd El Wahed, Ahmed Adel Hassan, Hamad General Hospital, Doha, Qatar
  • Alzalma, Ismail, Hamad General Hospital, Doha, Qatar
  • Alkadi, Mohamad M., Hamad General Hospital, Doha, Qatar
  • Al-Malki, Hassan A., Hamad General Hospital, Doha, Qatar
Background

Home hemodialysis HD (HHD) offers autonomy, cost benefits, and better quality of life. Uptake of HHD is limited by patient motivation and cognitive and physical barriers. Assisted HHD (AHHD) is a new concept where dialysis team provides HD at home but it is limited due to financial and logistics restriction. We are reporting success and outcomes of our AHHD program in the State of Qatar.

Methods

A Retrospective study of all HD patients who are enrolled in AHHD program between 7/2021 to 2/2023. Inclusion mainly for elderly patients requiring ambulance transportation to the dialysis center. Primary objective was effectiveness and safety of AHHD and secondary objectives were cost effectiveness and quality of life.

Results

85 patients enrolled in our AHHD program during study period with a mean follow up of 7 months (total 5968 HD treatments). Age was 71+/-10 years with 45% males. 13 patients died and 2 patients returned to dialysis center. We had 8 incidents of HD catheter malfunction and 20 technical incidents resolved without affecting program flow. No reported significant access bleeding, falls or hypotension episodes. We found a significant decrease of 43% in hospitalization rates compared to 6-month pre-study period. The program proved to be cost-effective, resulting in a reduction of costs by 27%, primarily attributed to savings in ambulance transport expenses. Key performance indicators, including adequacy, anemia, and mineral and bone management were maintained. In a survey, patients and families expressed an extraordinary level of satisfaction, with rates exceeding 98% in all assessed categories.

Conclusion

We present our program for AHHD, designed for frailed dialysis population. This initiative has yielded exceptional outcomes, substantial cost savings, exemplary safety measures, remarkable enhancements in quality of life, and an extraordinary level of patient satisfaction.

AHHD prevalence and mortality rate