title: Home care programme for patients with advanced chronic kidney disease. A two-year experience.
abstract: BACKGROUND
  &nbsp;Healthcare for patients with advanced chronic kidney disease (ACKD) on conservative treatment very often poses healthcare problems that are difficult to solve. Many patients are elderly and have mobility problems, and it is very difficult for them to travel to hospital. At the end of 2011, we began a programme based on the care and monitoring of these patients by Primary Care teams.&nbsp;
  
  
  METHODS
  &nbsp;ACKD patients who opted for conservative treatment were offered the chance to be cared for mainly at home by the Primary Care doctor, under the coordination of the Palliative Care Unit and the Nephrology Department.&nbsp;
  
  
  RESULTS
  &nbsp;During 2012 and 2013, 50 patients received treatment in this programme. Mean age: 81 years, Charlson age-comorbidity index: 10 and mean glomerular filtration rate: 11.8ml/min/1.73.m&sup2;. The mean patient follow-up time (until death or until 31/12/2013) was 184 days. During this period, 44% of patients did not have to visit the hospital&rsquo;s Emergency Department and 58% did not require hospitalisation. 29 of the 50 patients died after a mean time of 163 days on the programme; 14 (48%) died at home.&nbsp;
  
  
  CONCLUSIONS
  &nbsp;Our experience indicates that with the support of the Palliative Care Unit and the Nephrology Department, ACKD patients who are not dialysis candidates may be monitored at home by Primary Care.
authors.forename: José L
authors.initials: JL
authors.lastname: Teruel
authors.forename: Lourdes
authors.initials: L
authors.lastname: Rexach
authors.forename: Víctor
authors.initials: V
authors.lastname: Burguera
authors.forename: Antonio
authors.initials: A
authors.lastname: Gomis
authors.forename: Nuria
authors.initials: N
authors.lastname: Rodríguez-Mendiola
authors.forename: Alicia
authors.initials: A
authors.lastname: Díaz
authors.forename: Sergio
authors.initials: S
authors.lastname: Collazo
authors.forename: Carlos
authors.initials: C
authors.lastname: Quereda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000628:therapy*; D012720:Severity of Illness Index; D013997:Time Factors