Agar John W M, Mahadevan Kumar, Knight Richard, Antonis Michelle L, Somerville Christine A
Renal Unit, The Geelong Hospital, Barwon Health, Geelong, Victoria, Australia.
Nephrology (Carlton). 2005 Oct;10(5):525-9. doi: 10.1111/j.1440-1797.2005.00473.x.
Despite the advent of two new dialysis options, nocturnal home haemodialysis and short daily haemodialysis, many units are yet to build them into the modalities on offer to end-stage renal failure patients. The reasons behind this inertia are complex but primarily include anxieties about workload, budgetary implications and outcome data.
The Geelong dialysis programme, where both nocturnal home haemodialysis and short daily haemodialysis are offered, is compared with Australian and New Zealand national profiles.
Significant profile differences emerge when comparing sessions/week and h/week between the three groups. Most Australian (92.93%) and New Zealand (95.07%) haemodialysis patients dialyse for three sessions/week. This contrasts to Geelong where only 73.6% dialyse for three sessions/week. 18.8% of Geelong haemodialysis patients versus 1.8% (Australia) and 0.9% (New Zealand) dialyse for five or more sessions/week. Australia and New Zealand follow similar h/session patterns although more Australians (44.2%) dialyse for 4 h and fewer (24.2%) for 5 h than their New Zealand counterparts (39.6% and 29.8%, respectively), and few dialyse outside the 3.5-5 h window. In contrast, 6.7% of Geelong patients dialyse for 2-2.5 h/session versus Australia (0.9%) and New Zealand (0.2%). This represents the Geelong short daily dialysis programme. More Geelong patients (>15%) dialyse >/=8 h/week and represent the Geelong nocturnal home haemodialysis programme.
The flexible Geelong programme has been supported without exceeding the budget applied to a conventional dialysis programme with the same patient numbers.
尽管出现了两种新的透析方式，即夜间家庭血液透析和每日短时血液透析，但许多透析单位尚未将它们纳入为终末期肾衰竭患者提供的透析方式中。这种惰性背后的原因很复杂，但主要包括对工作量、预算影响和结果数据的担忧。
将提供夜间家庭血液透析和每日短时血液透析的吉朗透析项目与澳大利亚和新西兰的全国情况进行比较。
比较三组之间的每周透析次数和每周透析时长时，出现了显著的差异。大多数澳大利亚（92.93%）和新西兰（95.07%）的血液透析患者每周透析三次。这与吉朗的情况形成对比，在吉朗只有73.6%的患者每周透析三次。吉朗18.8%的血液透析患者每周透析五次或更多次，而澳大利亚为1.8%，新西兰为0.9%。澳大利亚和新西兰的每次透析时长模式相似，尽管澳大利亚每周透析4小时的患者（44.2%）比新西兰（分别为39.6%）更多，每周透析5小时的患者（24.2%）比新西兰（29.8%）更少，且很少有患者在3.5至5小时的窗口之外进行透析。相比之下，吉朗6.7%的患者每次透析2至2.5小时，而澳大利亚为0.9%，新西兰为0.2%。这代表了吉朗的每日短时透析项目。更多的吉朗患者（>15%）每周透析≥8小时，这代表了吉朗的夜间家庭血液透析项目。
灵活的吉朗项目在不超出适用于相同患者数量的传统透析项目预算的情况下得到了支持。
