[Home hemodialysis: the technical overview. A 2010 survey]

Abstract

Compared to the daily work in dialysis units, home haemodialysis represents a particular task for the technical services of healthcare facilities. This survey concerns this modality of treatment of end-stage chronic renal failure, and was led to three objectives: to make a snapshot of the practices done by the technical staff, to point out significant differences, and to identify common issues. This is also an opportunity to discuss about the future of this treatment. Numbers of registries show a continuous decline of home haemodialysis during past decades. This could be explained by many factors, but on the other hand several points tend to forecast a renewed interest for this method of treatment. A questionnaire was sent to every technical service of health organizations dispensing dialysis in France. Seventeen health facilities providing home haemodialysis have sent back their information, representing 238 patients, that to say almost the totality of the patients of the country. These data were analysed, relevant indicators were sorted out, so that initial objectives could be completed. The results are explained as follows: site activities, procedures before and during patient installation, equipment, preventive visits, and corrective maintenance. In lack of a precise regulation on the technical support of these patients, significant differences of operations were noted and are detailed, as well as several common difficulties. All these elements can be used as a basis for the development of a practical guide intended to technical services. This work is voluntarily centered on the technical aspects, but other levers exist to revitalize this method.