FP515NOTICEABLE DECREASE IN MEDICATION REQUIREMENT WITH NOCTURNAL HOME HEMODIALYSIS
Bildiriler > Özet Bildiri
Yazarlar: Cenk Demirci, Gülay AŞCI, Sinan Erten, Serkan Koc, Siddig Momin Adam, Fatih Kırcelli, Handan Ogunc, Taskin Colak, Ercan OK
Nephrology Dialysis Transplantation, , , Uluslararası, Özet Bildiri, Wos, cilt 30, ss iii244-iii244
Özet
Introduction and Aims: Hemodialysis (HD) patients have highly complex medication regimens and this is associated with medication-related problems, nonadherence and high total treatment cost. We investigated whether better control of blood pressure, anemia and mineral metabolism disturbances with nocturnal home HD reduces the requirement for antihypertensives, erythropoietin, phosphate-binders and vitamin D. Methods: Nocturnal home hemodialysis program was established in August 2010, in Turkey and achieved over 300 patients in December 2014 in 44 clinics operated by Fresenius Medical Care. We enrolled all 328 consecutive patients who started home HD and 328 propensity score-matched control cases remained on conventional HD (3x4h/week). All home HD patients received three-times weekly 7-8 h dialysis. Laboratory and medication data were collected at the start of home HD, 6th month and 12th month in home HD and at the same time-points in control cases. Results: There were no differences in baseline characteristics between two cohorts, including age, gender, diabetes, dialysis duration, systolic blood pressure, use of antihypertensive medications, hemoglobin, erythropoietin use, phosphate, calcium, parathormon, phosphate-binders use and vitamin D use. At the 12th month, phosphate (p<0.001), parathormon (p=0.003) and use of all mentioned medications were markedly lower in home HD group (p<0.001 for all) compared to conventional HD group; systolic blood pressure and hemoglobin were similar. Use of anti-hypertensive medications decreased from 33.8% to 12.1%, use of erythropoietin from 48.7% to 25.7%, use of phosphate-binders from 80.4% to 19.0%, use of vitamin D from 52.6% to 20.9% at the 12th month in home HD group. No change was observed in conventional HD group regarding the use of medication (Figure).