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At least 19 recordsLinked to original sources
PubMed1977

Whatever happened to home hemodialysis?

Advantages of home hemodialysis over center include better patient survival and rehabilitation, more patient convenience, decreased risk of hepatitis, and cheaper costs. Home dialysis places stress on the family and requires a great time commitment of the helper. Ninety-three patients began home dialysis training at our institution. Seventy-eight successfully completed training and five patients are still in training. Of the seventy-eight who completed training, fifty (64%) are still performing home dialysis for periods of from one month to 6 1/2 years. 10% received a kidney transplant, 13% died, and 13% have returned to a center for dialysis. Family stress was the major reason for return to a center in the ten patients who chose to do so. Even though home dialysis is superior to center dialysis, the percentage of patients being treated in the home in this country is diminishing. Possible reasons for this decline are discussed.

Family↗
PubMed1978

Medical management of home hemodialysis patients.

Increased emphasis on home hemodialysis because of proposed changes in federal funding will result in dispersion of dialysis patients to areas geographically removed from a dialysis unit. Thus primary care of these patients will increasingly become the responsibility of physicians having little previous contact with dialysis. We review the diagnosis and treatment of common problems in the dialysis patient with emphasis on the major problem areas of vascular access and the cardiovascular, hematologic, and osseous complications of renal failure.

Anemia↗
PubMed1977

Future of home hemodialysis.

An attempt to prophesy the future of home hemodialysis is based on anticipated near and long term technological improvements. Dialysis treatments will become shorter, due to pressure filtration, while extracting molecules in the 300 to 3000 dalton weight range through more permeable membranes. Portable and wearable dialysis systems will increase patient mobility. By the 21st century, implantable bionic kidneys and perfect host tolerance to renal allografts and xenografts will relegate home hemodialysis to history texts. A non-surgical definitive treatment for uremia is envisioned in the colonization of the human bowel with nitrogenn recycling bacteria.

Bionics↗
PubMed1979

Characteristics of patients with depressive disorder on entry into home hemodialysis.

During a prospective study of 58 patients entering home hemodialysis training, systematic interviews revealed that thirteen (22 per cent) of the patients were suffering depressive disorder. Depressed patients were more likely than nondepressed patients to have experienced a decline in job performance during the previous year, applied for disability income, and reduced leisure activities after the beginning of training. Further, the only two patients complaining of "quite a lot" of anxiety during dialyses were both found to be suffering depressive disorder. Polycystic kidney disease and depressive disorder were significantly positively associated in this patient sample. Possible implications of that association are discussed.

Adjustment Disorders↗
PubMed1979

Frequency of depressive disorder in patients entering home hemodialysis.

Fifty-eight patients were systematically interviewed at the time of their entry into a home hemodialysis training program. The social, demographic, medical, and psychological characteristics of the sample are described. On interview, 13 (22%) of the 58 patients were found to be experiencing rigorously defined depressive disorder. The importance of further study regarding the incidence of depressive illness in similar groups of patients and the need for further research in defining adequate therapy for these patients are emphasized.

Adjustment Disorders↗
PubMed1978

Home hemodialysis review in Iowa: 1970--1977.

One hundred fifty-two patients were accepted for home hemodialysis training from 1970 to 1976. Duration of training varied from 4 to 22 weeks. The primary reason for discontinuing home dialysis was patient and assistant psychological adjustment problems. Patient medical and technical problems were not related to the distance from the home dialysis training unit. Cumulative probability of survival was .948 at one year and .637 at five years. Cardiovascular disease accounted for 80% of the patients who died while receiving long-term hemodialysis. Fifty-three percent of the deaths in patients after renal transplantation were secondary to infectious causes.

Adaptation, Psychological↗
PubMed1976

Analysis and outcome of 1063 patients trained for home hemodialysis.

Between 1967 and 1973, 12 home dialysis training centers (HDTC), under contract to the health Resource Administration, Department of Health, Education, and Welfare, reported training 1063 patients. Mean training time was 69 days; mean patient age was 40 yr with a range of 12 to 75 yr. Survival rates were 87% at one year, 74% at two years, 62% at three years, 54% at four years and 52% at five years. Male to female ratio was 3.2; there was no significant survival difference between sexes. Patients under 50 yr of age had significantly greater survival than did patients 50 yr and older. A "good" health status classification, defined by activity tolerance, signs and symptoms at the beginning of home dialysis, was associated with more favorable survival than were lower health ratings. Patients with glomerulonephritis, pyelonephritis and polycystic disease had better survival than did patients with diabetic, hypertensive and other renal disease etiologies. Although 51% of the patients lived 50 to 400 or more miles from the HDTC, their survival was not different from patients living less than 50 miles from the HDTC. Survival rates for patients with less than ten years of education were not significantly different from those with formal education as high as the university graduate level. Forty-seven percent of the patients were restored to full activity. These survival results are comparable with those reported for other modes of dialysis and transplantation and indicate that home dialysis is an acceptable form of therapy for a variety of patients.

Activities of Daily Living↗
PubMed1979

[Use of the DIAPHANE information system for the monitoring of patients treated by home hemodialysis].

Data of the DIAPHANE Dialyse-Informatique system of the Society of Nephrology have been collected by patients just on a home dialysis program after training in the hemodialysis Unit of the Hospital of Montreuil. 35 patients have been using the computerized records since January 1978. A critical analysis of the first year has been made and results obtained have been compared with those obtained during the same period in patients dialysed in the Hospital. Results show that home dialysis patients are well able to fill in the computerized medical record concerning the dialysis session follow-up, and that the quality of the recorded information is similar to that recorded in hospital by nurses. Nevertheless few simplifications of home dialysis data sheet are considered. Computerized treatment of data collected on home dialysis program should allow useful comparisons required to improve the quality of care and expansion of this dialysis method.

Adult↗
PubMed1975

Hemodialysis in the home.

Hemodialysis can be performed safely and satisfactorily in the home. It is the method of choice for long-term maintence dialysis in properly selected patients and offers an excellent opportunity for porlonged survival and rehabilitation. Minimal criteria include the availability of an assistant, suitable physical facilities, appropriate age, adequate intellectual capacity and the potential for rehabilitation.

Age Factors↗