[Low flux dialysate daily home hemodialysis: A result for the 62 first French and Belgian patients]

Nephrol Ther. 2017 Feb;13(1):18-25. doi: 10.1016/j.nephro.2016.06.007. Epub 2016 Nov 18.
[Article in French]

Abstract

Since 2011, a new device is available for low flux dialysate quotidian home hemodialysis in France and Belgium. This study aims to evaluate the characteristics and dialysis prescriptions for Nx Stage System One™ users. We retrospectively included patients trained between 2011 and 2013 in France and Belgium. We collected data concerning their clinical features, their dialysis prescriptions, their laboratory parameters until 6 months of dialysis and, reason for dropping in case of cessation. Sixty-two patients from 31 centers, aged 48±18 years old, with a sex ratio 46/16 (M/F) are included with a median Charlson comorbidity index of 1 [0-3]. Of these patients, 71% are anuric and have been on dialysis for a mean time of 136.6±125 months. Previously, most of them had been taken care of in satellite units of dialysis (45%) and 14% are incident patients. In total, A total of 60% have an arterio-veinous fistula (AVF), with 18 patients using the Buttonhole system and 2 patients have a tunneled catheter. Median time for training was 26.5 days (17-45). Among the patients, 69% are dialyzed 6 days a week, during a mean time of 142.5±20 minutes with a volume of 20.9±3 liters of dialysate and without anticoagulant (63%). Predialytic levels of hemoglobin, creatinin, urea, phosphorus and β2microglobulin remain stable. On the contrary, there is a significant improvement of albumin and bicarbonate levels. Technique survival was 75% at 1 year, and major reason for cessation was kidney transplant. It seems that this device fits for young patients, with few comorbidities and a long past in renal chronic failure. These results suggest that dialysis adequacy is acceptable despite low dialysate volumes but need confirmation with a longer follow up and a larger cohort.

Keywords: Bas débit de dialysat; Home; Hémodialyse quotidienne; Low flux dialysate; Quotidian hemodialysis; Soins à domicile.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Belgium
  • Bicarbonates / blood
  • Comorbidity
  • Dialysis Solutions / administration & dosage*
  • Female
  • France
  • Hemodialysis, Home* / instrumentation
  • Hemodialysis, Home* / methods
  • Humans
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Serum Albumin / analysis

Substances

  • Bicarbonates
  • Dialysis Solutions
  • Serum Albumin