Nocturnal home hemodialysis: implementation, quality assurance and future challenges.
Nocturnal home hemodialysis (NHHD) has been associated with several clinical benefits compared to conventional thrice-weekly in-center hemodialysis. However, the prevalence of NHHD remains low. To date, few studies have focused on the importance of training and education of a complex medical procedure such as NHHD. In the present review, we will describe guidelines for implementation of a NHHD program by focusing on 1) patients' selection, assessment and training; 2) challenges of adult education; 3) prescription and 4) barriers to adoption of home hemodialysis. Future challenges in research, the importance of quality assurance and innovations in clinical care delivery in NHHD will also be discussed.
Rioux
J P
JP
Division of Nephrology, Department of Medicine, University Health Network, Toronto, ON, Canada.
Faratro
R
R
Chan
C T
CT
D002408:Catheters, Indwelling / Q000191:economics; D002940:Circadian Rhythm; D007722:Health Knowledge, Attitudes, Practice; D006437:Hemodialysis, Home / Q000191:economics / Q000379:methods; D006801:Humans; D007676:Kidney Failure, Chronic / Q000191:economics / Q000628:therapy*; D010353:Patient Education as Topic; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care / Q000191:economics; D011788:Quality of Life; D018570:Risk Assessment