Résultats préliminaires et étude médico-économique d’un programme d’hémodialyse quotidienne à domicile dans un centre d’hémodialyse privé

Hémodialyse Quotidienne à Domicile

Auteurs

  • Hadia Hebibi Nephocare, Villejuif
  • Magali Ciroldi Nephrologue, NephroCare Villejuif
  • Laure Cornillac Fresenius Medical Care, Ile de France, France
  • Samah Saibi NephroCare ile de France
  • Fatia El Boundri NephroCare ile de France
  • Charles Chazot NephroCare France, Fresenius Medical Care https://orcid.org/0000-0002-6509-420X
  • David Attaf CH Pierre Bérégovoy, 1 rue Guillot 58000 Nevers https://orcid.org/0000-0001-8326-8261

DOI :

https://doi.org/10.25796/bdd.v4i2.61653

Mots-clés :

NxStage, Button-hole, hémodialyse quotidienne, Kt/V hebdomadaire, hémodialyse à domicile

Résumé


Introduction : En France, entre 2015 et 2017 on note une progression de 40% de l’hémodialyse quotidienne (HDQ), selon le registre REIN. Celle-ci concerne moins de 1% de la population dialysée et le secteur privé restant sous-représenté.
Matériels et méthodes : Notre étude rétrospective a pour objectifs de décrire les résultats cliniques, les spécificités organisationnelles et medico-économiques de cette technique dans un centre d’hémodialyse privé.
Résultats :Entre le 01/02/2020 et 30/04/2021, 12 patients ont été formés. La moyenne d’âge est de 45 ans (28-71) avec une sex-ratio 4/8 (H/F) et un score de Charlson médian à 3. 58% des patients étaient en auto-dialyse. La résiduelle moyenne est de 700 ml/24h, 50% des patients sont anuriques. 100% étaient dialysés sur fistule artérioveineuse. La technique de la boutonnière est utilisée chez 100% des patients. Le temps médian de formation était de 35 jours (28-35). 83% des patients étaient dialysés 6 jours/semaine avec une durée moyenne de 210 minutes (130-150) par séance, avec un volume moyen de dialysat de 24.58 litres. 10 patients n’avaient pas d’anticoagulant. Une patiente a développé une allergie à la membrane PUREMA® motivant son switch vers une autre membrane. L’hémoglobinémie, la créatininémie, l’urémie, la phosphorémie et la bêta-2microglobulinémie pré-dialytiques sont stables à 9 mois, avec une amélioration significative de l’acidose métabolique. La survie de la technique est de 83% à 12 mois. La principale cause de sortie de technique étant la transplantation rénale. 3 patients ont repris une activité professionnelle.
Conclusion :Nos résultats préliminaires suggèrent que l’HDQ offre une bonne qualité de dialyse et une meilleure insertion socio-professionnelle.

 

Bibliographies de l'auteur

Hadia Hebibi, Nephocare, Villejuif

Nephrologue, service de néphrologie et transplantation renale CHU Kremlin Bicêtre, 94270 Kremlin Bicêtre 

David Attaf, CH Pierre Bérégovoy, 1 rue Guillot 58000 Nevers

Directeur medical Fresenius Medical Care 

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Publiée

2021-05-20

Comment citer

1.
Hebibi H, Ciroldi M, Cornillac L, Saibi S, El Boundri F, Chazot C, Attaf D. Résultats préliminaires et étude médico-économique d’un programme d’hémodialyse quotidienne à domicile dans un centre d’hémodialyse privé: Hémodialyse Quotidienne à Domicile. Bull Dial Domic [Internet]. 20 mai 2021 [cité 22 déc. 2024];4(2):105-19. Disponible sur: https://bdd.rdplf.org/index.php/bdd/article/view/61653