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Shah N, Reintjes F, Courtney M, et al. Quality Assurance Audit of Technique Failure and 90-Day Mortality after Program Discharge in a Canadian Home Hemodialysis Program. Clin J Am Soc Nephrol. 2017;doi: 10.2215/CJN.00140117.
Shah, N., Reintjes, F., Courtney, M., Klarenbach, S. W., Ye, F., Schick-Makaroff, K., Jindal, K., & Pauly, R. P. (2017). Quality Assurance Audit of Technique Failure and 90-Day Mortality after Program Discharge in a Canadian Home Hemodialysis Program. Clinical journal of the American Society of Nephrology : CJASN, . https://doi.org/10.2215/CJN.00140117
Shah, Nikhil, et al. "Quality Assurance Audit of Technique Failure and 90-Day Mortality after Program Discharge in a Canadian Home Hemodialysis Program." Clinical journal of the American Society of Nephrology : CJASN vol. (2017). doi: https://doi.org/10.2215/CJN.00140117
Shah N, Reintjes F, Courtney M, Klarenbach SW, Ye F, Schick-Makaroff K, Jindal K, Pauly RP. Quality Assurance Audit of Technique Failure and 90-Day Mortality after Program Discharge in a Canadian Home Hemodialysis Program. Clin J Am Soc Nephrol. 2017 Jul 24; doi: 10.2215/CJN.00140117. Epub 2017 Jul 24. PMID: 28739573; PMCID: PMC5544501.
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Clin J Am Soc Nephrol. 2017 Jul 24; doi: 10.2215/CJN.00140117. Epub 2017 Jul 24.

Quality Assurance Audit of Technique Failure and 90-Day Mortality after Program Discharge in a Canadian Home Hemodialysis Program.

Clinical journal of the American Society of Nephrology : CJASN

Nikhil Shah, Frances Reintjes, Mark Courtney, Scott W Klarenbach, Feng Ye, Kara Schick-Makaroff, Kailash Jindal, Robert P Pauly

Affiliations

  1. Division of Nephrology, Department of Medicine and.
  2. Northern Alberta Renal Program, Alberta Health Services, Edmonton, Alberta, Canada; and.
  3. Alberta Kidney Disease Network, Edmonton, Alberta, Canada.
  4. Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
  5. Division of Nephrology, Department of Medicine and [email protected].

PMID: 28739573 PMCID: PMC5544501 DOI: 10.2215/CJN.00140117

Abstract

BACKGROUND AND OBJECTIVES: Little is known about patients exiting home hemodialysis. We sought to characterize the reasons, clinical characteristics, and pre-exit health care team interactions of patients on home hemodialysis who died or underwent modality conversion (negative disposition) compared with prevalent patients and those who were transplanted (positive disposition).

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted an audit of all consecutive patients incident to home hemodialysis from January of 2010 to December of 2014 as part of ongoing quality assurance. Records were reviewed for the 6 months before exit, and vital statistics were assessed up to 90 days postexit.

RESULTS: Ninety-four patients completed training; 25 (27%) received a transplant, 11 (12%) died, and 23 (25%) were transferred to in-center hemodialysis. Compared with the positive disposition group, patients in the negative disposition group had a longer mean dialysis vintage (3.15 [SD=4.98] versus 1.06 [SD=1.16] years;

CONCLUSIONS: Over a 6-year period, approximately one third of patients exited the program due to death or modality conversion. Patients who die or transfer to another modality have significantly higher health care resource utilization (

Copyright © 2017 by the American Society of Nephrology.

Keywords: Burnout, Professional; Canada; Caregivers; Hemodialysis, Home; Home hemodialysis; Humans; Patient Care Team; Patient Discharge; Prevalence; Vital Statistics; hospitalization; intensive hemodialysis; modality conversion; mortality; program exits; renal dialysis; technique failure; technique survival; therapy cessation; training failure; transplantation; treatment discontinuation

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