Intensive Hemodialysis in the (Nursing) Home: the Bright Side of Geriatric ESRD Care?
Article first published online: 19 OCT 2012
© 2012 Wiley Periodicals, Inc.
Seminars in Dialysis
Volume 25, Issue 6, pages 605–610, November/December 2012
How to Cite
Cornelis, T., Kotanko, P., Goffin, E., van der Sande, F. M., Kooman, J. P. and Chan, C. T. (2012), Intensive Hemodialysis in the (Nursing) Home: the Bright Side of Geriatric ESRD Care?. Seminars in Dialysis, 25: 605–610. doi: 10.1111/sdi.12011
- Issue published online: 22 NOV 2012
- Article first published online: 19 OCT 2012
Elderly ESRD patients often lose functionality when they start dialysis, which may be due to a variety of clinical problems. We recently postulated that intensive (longer and/or more frequent) hemodialysis (HD) may be the ideal strategy to try to prevent these ESRD- and dialysis-related complications, including dialysis-induced hypotension, cardiac and cerebral events, malnutrition, infections, sleep problems, and psychological issues. The feasibility of home dialysis therapies has been demonstrated in observational studies. As self-care dialysis is often a challenge in the elderly patient, assisted intensive home HD may facilitate the long-term continuation of this modality. Intensive nursing home HD seems to be an attractive goal for the future because many elderly ESRD patients reside in an extended care facility. Combination with rehabilitation and support by social worker and psychologist remains crucial in the holistic approach toward the elderly ESRD patient. Further studies are required to test the potential protective effects of intensive HD on functionality and quality of life in elderly ESRD patients, and to elucidate the mechanisms underlying frailty and other geriatric syndromes in this highly vulnerable patient population.