ACMJ
Anatolian Current Medical Journal

Anatolian Current Medical Journal (ACMJ) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

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Original Article
Predialysis education program and early vascular access: a single center experience
Abstract
Aims: The main objective of this study is to investigate the impact of a pre-dialysis education program on the selection of vascular access during the initiation of maintenance hemodialysis therapy and the short-term impact of this education on patient outcomes.
Methods: The data were collected from two different times in the past from patients under maintenance hemodialysis: the first group consisted of a group of patients who received a predialysis education program (intervention group) from a dedicated nephrologist, and the second group included those who did not undergo a control program (control group). Predialysis education program involved six modules addressing understanding kidney disease, diet, and nutrition, treatment options for end-stage kidney disease, dialysis procedures, medication management, and self-care/independence. Patients aged ?18 years were enrolled in the study. The patients were compared according to their clinical status during the onset of maintenance hemodialysis, including vascular access type, serum potassium level, previous hospitalization, and urgent hemodialysis need. Additionally, the hospitalization and infection rates within 6 months following the onset of maintenance hemodialysis were compared. P<0.05 was assigned as significant.
Results: A total of 203 hemodialysis patients, 129 patients in the intervention group and 74 patients in the control group, were assessed. The mean age was 65.06±13.14 for the intervention versus 65.66±9.13 for the control group (p=0.729). 51.9% (n=67) in the intervention group versus 55.4% (n=41) were females (p=0.371). The control group had more hospitalization (p<0.001), intervention need of vascular access problems (p<0.001), vascular access infection (<0.001), exposure to an intermittent catheter (<0.001), 127 of 129 patients in the intervention group started hemodialysis with an arteriovenous fistula. The control group started hemodialysis with a catheter Potassium, phosphorus, and bicarbonate levels were higher in the control group during the first hemodialysis session (5.25±1.12 vs 4.59±0.79, p<0.001, 6.60±1.18 vs 4.25±1.04, p<0.001, and 21.77±3.96 vs 14.18±2.83, p<0.001, respectively).
Conclusion: This study demonstrated that a well-organized education program can lower the burden of morbidity in end-stage kidney disease and support the patient and healthcare providers with a favorable transmission from a non-hemodialysis period to a hemodialysis period.

Keywords : End-stage kidney disease, pre-dialysis education, maintenance hemodialysis, morbidity, vascular access

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1. Hill NR, Fatoba ST, Oke JL, Hirst JA, et al. Global prevalence ofchronic kidney disease - a systematic review and meta-analysis.PLoS One. 2016;11(7):e0158765.
2. Glassock RJ, Warnock DG, Delanaye P. The global burden ofchronic kidney disease: estimates, variability and pitfalls. Nat RevNephrol. 2017;13(2):104-114.
3. Fluck R, Kumwenda M. Renal Association Clinical PracticeGuideline on vascular access for haemodialysis. Nephron ClinPract. 2011;118 Suppl 1:c225-c240.
4. Hoggard J, Saad T, Schon D, et al. Guidelines for venous accessin patients with chronic kidney disease. A Position Statementfrom the American Society of Diagnostic and InterventionalNephrology, Clinical Practice Committee and the Associationfor Vascular Access. Semin Dial. 2008;21(2):186-191.
5. Levin A, Lewis M, Mortiboy P, et al. Multidisciplinary predialysisprograms: quantification and limitations of their impact onpatient outcomes in two Canadian settings. Am J Kidney Dis. 1997;29(4):533-540.
6. Chanouzas D, Ng KP, Fallouh B, Baharani J. What influencespatient choice of treatment modality at the pre-dialysis stage?Nephrol Dial Transplant. 2012;27(4):1542-1547.
7. Van den Bosch J, Warren DS, Rutherford PA. Review of predialysiseducation programs: a need for standardization. Patient PreferAdherence. 2015;9:1279-1291.
8. Lin MY, Cheng LJ, Chiu YW, et al. Effect of national pre-ESRD care program on expenditures and mortality in incidentdialysis patients: a population-based study. PLoS One.2018;13(6):e0198387.
9. Campbell-Montalvo R, Jia H, Shukla AM. Supporting shareddecision-making and home dialysis in end-stage kidney disease.Int J Nephrol Renovasc Dis. 2022;15:229-237.
10. Kalantar-Zadeh K, Lockwood MB, Rhee CM, et al. Patient-centred approaches for the management of unpleasant symptomsin kidney disease. Nat Rev Nephrol. 2022;18(3):185-198.
11. Murea M, Grey CR, Lok CE. Shared decision-making inhemodialysis vascular access practice. Kidney Int. 2021;100(4):799-808.
12. Combes G, Sein K, Allen K. How does pre-dialysis educationneed to change? findings from a qualitative study with staff andpatients. BMC Nephrol. 2017;18(1):334.
13. Jia T, Bi SH, Lindholm B, Wang T. Effect of multi-dimensionaleducation on disease progression in pre-dialysis patients inChina. Ren Fail. 2012;34(1):47-52.
14. Singhal R, Hux JE, Alibhai SMH, Oliver MJ. Inadequatepredialysis care and mortality after initiation of renal replacementtherapy. Kidney Int. 2014;86(2):399-406.
15. Craig JC, Molony DA, Strippoli GFM. Evidence-BasedNephrology, 2 Volume Set. John Wiley &amp; Sons; 2022.
16. Dsouza B, Prabhu R, Unnikrishnan B, et al. Effect of educationalintervention on knowledge and level of adherence amonghemodialysis patients: a randomized controlled trial. Glob HealthEpidemiol Genom. 2023;2023:4295613.
17. Saran R, Bragg-Gresham JL, Rayner HC, et al. Nonadherence inhemodialysis: associations with mortality, hospitalization, andpractice patterns in the DOPPS. Kidney Int. 2003;64(1):254-262.
18. Parvan K, Hasankhani H, Seyyedrasooli A, Riahi SM, GhorbaniM. The effect of two educational methods on knowledge andadherence to treatment in hemodialysis patients: clinical trial. JCaring Sci. 2015;4(1):83-93.
19. Tarverdizade Asl P, Lakdizaji S, Ghahramanian A, SeyedrasooliA, Ghavipanjeh Rezaiy S. Effectiveness of text messaging and faceto face training on improving knowledge and quality of life ofpatients undergoing hemodialysis: a randomized clinical trial. JCaring Sci. 2018;7(2):95-100.
20. Shimizu Y, Nakata J, Yanagisawa N, et al. Emergent initiation ofdialysis is related to an increase in both mortality and medicalcosts. Sci Rep. 2020;10(1):19638.
Article available in :
Volume 5, Issue 4, 2023
Page : 355-359
https://doi.org/10.38053/acmj.1331260
Article Information
Received : 22 Tem 2023
Accepted : 22 Ağu 2023
Published : 27 Eki 2023
Corresponding Author :

Mahmud İslam: Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Sakarya University, Sakarya, Turkey

[email protected]
Citation : İslam M, Öztop KE. Predialysis education program and early vascular access: a single center experience. Anatolian Curr Med J. 2023;5(4):355-359.

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