Nephrologists-perspectives on dialysis treatment: results of an international survey

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• 作者：Richard J Fluck (1)
  Denis Fouque (2)
  Robert S Lockridge Jr (3)
  
• 关键词：End ; stage renal disease ; In ; centre haemodialysis ; Home ; based haemodialysis ; Practitioner attitudes ; High ; dose haemodialysis
• 刊名：BMC Nephrology
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：15
• 期：1
• 全文大小：200 KB
• 作者单位：Richard J Fluck (1)
  Denis Fouque (2)
  Robert S Lockridge Jr (3)
  
  1. Department of Nephrology, Royal Derby Hospital, Derby, UK
  2. Department of Nephrology, H?pital Edouard Herriot, Lyon, France
  3. Division of Nephrology, University of Virginia Health System, Charlottesville, VA, USA
  
• ISSN：1471-2369

文摘

Background In-centre haemodialysis (ICHD) is the most common dialysis method used by patients worldwide. However, quality of life and clinical outcomes in patients treated via ICHD have not improved for some time. ‘High-dose-haemodialysis (HD) regimens -which are longer and/or more frequent than conventional regimens and are particularly suitable to delivery in the home -may offer a route to improved outcomes and quality of life. This survey aimed to determine nephrologists-views on the validity of alternatives to ICHD, particularly home HD and high-dose HD. Methods A total of 1,500 nephrologists from Europe, Canada and the United States were asked to respond to an online questionnaire that was designed following previous qualitative research. Certified nephrologists in practice for 2-5?years who managed >25 adult dialysis patients were eligible to take part. Results A total of 324 nephrologists completed the survey. ICHD was the most common type of dialysis used by respondents-current patients (90%), followed by peritoneal dialysis (8%) and home HD (2%). The majority of respondents believed that: home HD provides better quality of life; increasing the frequency of dialysis beyond three times per week significantly improves clinical outcomes; and longer dialysis sessions performed nocturnally would result in significantly better clinical outcomes than traditional ICHD. Conclusions Survey results indicated that many nephrologists believe that home HD and high-dose HD are better for the patient. However, the majority of their patients were using ICHD. Education, training and support on alternative dialysis regimens are needed.