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Nephrol Dial Transplant (2003) 18: 16-18
© 2003 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Frequent prolonged home haemodialysis: three old concepts, one modern solution

Menno P. Kooistra

Dianet Dialysis Centres, Utrecht, The Netherlands

Keywords: adequacy; daily haemodialysis; haemodialysis; nocturnal haemodialysis; prolonged haemodialysis

The first 150 words of the full text of this article appear below.

Adequacy redefined

Most haemodialysis patients are, even when treated ‘adequately’ according to current standards, exposed to the so-called unphysiology of dialysis, which was described more than 25 years ago [1]. They are still at high risk of being overhydrated and dehydrated, hypertensive and hypotensive, acidotic and alkalotic, or hyperkaliaemic and hypokaliaemic thrice weekly. Furthermore, most patients are treated in an unfamiliar hospital setting where they are confronted with illness and death of fellow patients and chronic lack of time of overworked professionals, resulting in neglect of attempts of patients to self-determination. Despite many good evidence-based protocols and standards, current chronic intermittent haemodialysis is associated with high mortality and morbidity and low quality of life, and hardly deserves the adjective ‘adequate’. Dialysis should be referred to as ‘adequate’ when it results in normal life expectancy, normal morbidity, normal quality of life and the absence of dialysis-associated symptoms. We are challenged . . . [Full Text of this Article]

Old concept no. 1: frequent haemodialysis
Old concept no. 2: prolonged haemodialysis
Old concept no. 3: home haemodialysis
Three old concepts, one new solution: nocturnal home haemodialysis

Conclusion


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