Estado actual de la utilización de la hemodiálisis domiciliaria: revisión integrativa

Abstract

Objective: To know the existing scientific literature on the current state of home hemodialysis.
Material and Method: An integrative review has been carried out through a search of Pubmed, Scopus and Google Academic databases. Original scientific and review articles were included, in English and Spanish, excluding those articles that did not present results or that were not in full text.
Results: Twenty-three articles published between 2012 and 2017 have been included. Home hemodialysis is rarely used in the world, apart from Australia and New Zealand. The published series reported better survival in patients on daily or intensive home hemodialysis, compared to other types of renal replacement therapy, as well as better clinical results. The main advantages of the technique are the flexibility in daily life and the independence of the health center. As main drawback, an increase in infections associated with the use of central venous catheters or buttonhole puncture technique was shown.
Conclusions: Home hemodialysis has the main advantage of greater freedom and flexibility for the patient, for the management of their own treatment. The main drawback is a higher probability of suffering infections, related to vascular access. When daily or intensive home hemodialysis is performed, the clinical results are better than the other dialysis procedures, being comparable to those of kidney transplantation. The role of nursing is fundamental in the development of this technique, especially in the key process of patient and family education.