Year: 2024
Type: article
Abstract: Aim: Review dialysis prescription, haemodialysis adequacy and patient quality of life in stable maintenance haemodialysis patients at the Concord Repatriation General Hospital (CRGH).We aim to identify patients for a more personalised dialysis prescription by altering the duration of haemodialysis, improving quality of life (QoL) and provision of greener dialysis.Background: Haemodialysis generates a disproportionately high carbon footprint when compared to other medical therapies.Current guidelines recommend haemodialysis prescription of 4 hours dialysis thrice weekly.Dialysis adequacy is poorly defined but includes biochemical markers (Kt/V), patient QoL and nutritional assessment.Methods: We conducted a cross sectional audit of all stable haemodialysis patients at CRGH by reviewing their dialysis prescription, ultrafiltration requirement and nutritional status.Patients were divided into quintiles by mean monthly Kt/V with the top quintile assessed for suitability of reduced HD hours.Safety assessment included pre-dialysis potassium and average ultrafiltration.Patients found suitable for reduced hours were referred to their usual nephrologist to make a final decision on dialysis prescription.Results: 123 patients were included, 25 patients in the top kt/V quintile had a mean Kt/V of 1.94 (Range 1.75-2.16).This population was 76% female with a median age of 77 years, mean BMI of 22 kg/m2, albumin 32 g/L and pre-dialysis potassium 4.7 mmol/L.Mean duration of dialysis was 4.9 hours, thrice weekly.After safety considerations 16 patients were identified who may be appropriate for reduction in HD hours.Conclusions: Review of dialysis prescription and routine biochemistry identifies a subset of patients who may be appropriate for reduced dialysis hours.Reducing hours by 30 minutes each in this cohort could save at least 48 672 L of water per year.
Source: Nephrology
DOI: 10.1111/nep.14362
Authors: Review dialysis prescription, haemodialysis adequacy and patient quality of life in stable maintenance haemodialysis patients at the Concord Repatriation General Hospital (CRGH). We aim to identify patients for a more personalised dialysis prescription by altering the duration of haemodialysis, improving quality of life (QoL) and provision of greener dialysis.
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4401870547