Division of Nephrology, University Health Network, Toronto, ON, Canada.
Division of Nephrology, University Health Network, Toronto, ON, Canada.
Adv Chronic Kidney Dis. 2021 Mar;28(2):184-189. doi: 10.1053/j.ackd.2021.04.003.
Nocturnal hemodialysis is a form of intensive hemodialysis, which may be done in center or at home. Despite the documented clinical and economic benefits of ncturnal hemodialysis, uptake of this modality has been relatively low. In this review, we aim to address the potential barriers and possible mitigation strategies. Among the patient-related barriers, lack of knowledge and awareness remains the most common barrier, while administrative inertia to change from conventional in-center hemodialysis continues to be a challenge. Current global effort to grow home dialysis will re-focus the need for better patient education, innovate home dialysis technology, and evolve new models of care. New patient-focused policy will allow changes in reimbursement and develop appropriate momentum toward an integrated "home first model" to kidney replacement therapy.
夜间血液透析是一种强化血液透析形式，可在中心或家中进行。尽管夜间血液透析具有已被记录的临床和经济效益，但这种模式的采用率相对较低。在这篇综述中，我们旨在解决潜在的障碍和可能的缓解策略。在与患者相关的障碍中，缺乏知识和意识仍然是最常见的障碍，而改变传统中心血液透析的行政惰性仍然是一个挑战。目前全球促进家庭透析的努力将重新聚焦于更好的患者教育、创新家庭透析技术以及发展新的护理模式的必要性。新的以患者为中心的政策将允许改变报销，并为朝着整合的“家庭优先模式”发展以替代肾脏替代疗法的方向发展提供适当的动力。
