THE EFFECT OF INTENSIFIED HOME HAEMODIALYSIS TRAINING: A SINGLE CENTRE EXPERIENCE

G STONIER, E TAN

Regional Renal Unit, Waikato Hospital, Hamilton, New Zealand

Aim:  To ascertain the effects of increased Home Haemodialysis (HHD) training intensity on overall training time.

Background: Our renal unit has 95 prevalent HHD patients. The same staff train and subsequently look after these patients. Pre-2011, conventional training takes 8-12 weeks: Thrice Weekly (TW) coinciding with dialysis, with gaps in the week. From 2011 onwards, an Intensified Training Regime (ITR) was employed: Four Times Weekly (FTW).

Methods: Data was retrospectively collected from 2005-2015 for patients undergoing HHD training (which included new and previously trained patients). The age, gender, ethnicity, diabetic status and training duration were compared between the groups of different intensities: TW versus FTW (using t-test for statistical analysis).

Results: The baseline characteristics of these cohorts (TW versus FTW) were as follows: total numbers (103 versus 139 patients), average age (50.0±1.1 versus 50.8±1.0 years), males (64.3% versus 74.8%), indigenous people (61.38% versus 67.6%) and diabetes status (49.5% versus 53.9%). The ITR reduced overall training times (9.55±0.39 versus 7.4±0.27 weeks, p<0.001). Sub-analysis showed that only newly trained patients benefited from the ITR (10.98±0.39 versus 8.19±0.28 weeks, p<0.001). For previously trained patients, retraining times remained unchanged (5.78±0.53 versus 5.03±0.52 weeks, p=0.32).

Conclusions: The ITR was associated with significantly shorter overall training times. This improvement was only seen in newly recruited patients but not in previously trained patients.

Discussion: The ITR utilises the training week more efficiently; allowing earlier HHD establishment and faster through-put of patients, which may translate to cost savings. However, this arrangement requires more staffing commitment for training, with potentially less time to look after existing patients. Also, a more relaxed training regime (TW) could be considered when retraining patients who were previously trained.

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The ASM is hosted by Australian and New Zealand Society of Nephrology.

The aims of the Society are to promote and support the study of the kidney and urinary tract in health and disease, and to ensure the highest professional standards for the practice of nephrology in Australia and New Zealand.

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