Home dialysis : what are the barriers . A French nephrologist survey

  • Magalie Geneviève Service de Néphrologie-Dialyse, Clinique Francheville, Périgueux https://orcid.org/0000-0003-3941-8124
  • Stanislas Bataille Service de Néphrologie-Dialyse, Institut Phocéen de Néphrologie, Marseille https://orcid.org/0000-0001-8344-1300
  • Julie Beaume 3Service de Néphrologie-Dialyse, association AVODD, Toulon
  • Aldjia Hocine Service de Néphrologie-Dialyse, Clinique du Landy, Saint Ouen
  • Louis De Laforcade Service d’Endocrinologie-Néphrologie, Centre Hospitalier de Bourgoin-Jallieu https://orcid.org/0000-0002-5958-8924
  • Anne-Sophie Garnier Service de Néphrologie-Dialyse-Transplantation, CHU Angers, Angers https://orcid.org/0000-0002-3236-3899
  • Come Bureau Service de Réanimation Médicale, CHU La Pitié Salpétrière, Paris
  • Flora Brunner Service de Néphrologie, CHU Reims, Reims
  • Antoine Braconnier Service de Néphrologie, CHU Reims, Reims
  • Guilllaume Seret Service de Néphrologie-Dialyse, Association ECHO, Le Mans https://orcid.org/0000-0002-9962-7537
Keywords: home dialysis, barriers to home dialysis, peritoneal dialysis, dialyse à domicile, freins, dialyse péritonéale

Abstract

Home dialysis, which includes Peritoneal Dialysis and Home Hemodialysis, provides lots of profit to patients suffering of Chronic Kidney Disease, especially in terms of comfort, life quality and autonomy. However, its use is marginal in France, with an inhomogenous distributaion according to geographical regions. We conducted a French national survey of nephrologists to assess the barriers to the development of home dialysis. After analyzing the responses of the 230 participating nephrologists, the main obstacles to the development of the two techniques were identified and classified according to their reporting rate. The major obstacles that emerge from the survey are : the lack of information among the general public, a lack of acknowledgement of nurses specializing in these techniques, the limited number of structures that practice dialysis at home, and information difficulties among patient about dialysis techniques. The specific peritoneal dialysis-related difficulties reported are : difficulties in management of follow-up care and rehabilitation, the fear of insufficient purification and the difficulties related to the dialysis catheter. Concerning home hemodialysis, the barriers concern fear of autopunction and the need for a third party. This study helps to identify the representations of nephrologists on the major obstacles to the development of home dialysis to develop lines of thought for its promotion, both in terms of training, institutional acknowledgement, and the necessary regulatory evolution.

Published
2019-06-15