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Journal of Nephrology

, Volume 28, Issue 4, pp 485–493 | Cite as

Hemodialysis in satellite dialysis units: incidence of patient fallback to the in-center dialysis unit

  • Aurore Barthelemy
  • Thierry LobbedezEmail author
  • Clemence Bechade
  • Patrick Henri
  • Jean-Marie Batho
  • Eric Cardineau
  • Alain Jeanson
  • Isabelle Landru
  • Françoise Lefort
  • Jacky Potier
  • Elie Zagdoun
  • Pascal Thibon
Original Article
  • 165 Downloads

Abstract

Background

Patient fallbacks occur when a patient treated in a satellite dialysis unit (SDU) must be transferred to an in-center dialysis unit. Fallbacks have an impact on the in-center dialysis unit organization. This study was carried out to estimate the incidence and risk factors of patient fallback.

Methods

Between 01/01/2006 and 31/12/2010 there were 193 patients starting dialysis in SDUs in one French region. The primary outcome was the incidence of temporary and permanent fallbacks with or without hospitalization. A survival analysis and binomial negative regression were used for the statistical analysis.

Results

Among the 193 patients, 117 (60.6 %; 95 % confidence interval [CI]: 53.3–67.6) had at least one fallback, which occurred within a median of 249 days (interquartile range [IQR]: 71–469) after the first session in the SDU. The median number of fallbacks by subject was 1 (IQR: 0–4). The median duration of the fallback period was 4 days (IQR: 1–8) and median number of dialysis sessions during the fallback time was 1 (IQR: 1–3). Of the 494 temporary fallbacks, 210 were due to patient hospitalization, the main cause of which was cardiovascular disease. At univariate analysis, patients permanently transferred to in-center hemodialysis units were older, had more peripheral arteriopathy, cancer and arrhythmia. At multivariate analysis, peripheral arteriopathy (relative risk [RR] 2.06, 95 % CI 1.05–4.09) and the center (center 2: RR 0.42, 95 % CI 0.21–0.84; center 3: RR 2.88, 95 % CI 1.20–6.91) were significantly associated with the number of fallbacks.

Conclusion

Fallback is a common event in hemodialysis patients treated in SDUs. Yet, the SDU system operates well since a third of patients treated in these units are still in SDUs at 2 years of follow-up. Factors associated with patient fallback are the center and cardiovascular disease.

Keywords

Hemodialysis Satellite hemodialysis Transfer 

Notes

Conflict of interest

The authors have do not have any conflict of interest.

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Copyright information

© Italian Society of Nephrology 2014

Authors and Affiliations

  • Aurore Barthelemy
    • 1
    • 2
  • Thierry Lobbedez
    • 2
    • 10
    Email author
  • Clemence Bechade
    • 1
    • 2
  • Patrick Henri
    • 2
  • Jean-Marie Batho
    • 1
    • 3
  • Eric Cardineau
    • 4
  • Alain Jeanson
    • 5
  • Isabelle Landru
    • 6
  • Françoise Lefort
    • 7
  • Jacky Potier
    • 8
  • Elie Zagdoun
    • 9
  • Pascal Thibon
    • 1
  1. 1.Renal Epidemiology and Information Network, CHU de CaenCaenFrance
  2. 2.CHU de Caen, NephrologyCaenFrance
  3. 3.CHP Saint-Martin, NephrologyCaenFrance
  4. 4.CH Inter-communal Alençon-Mamers, NephrologyAlençonFrance
  5. 5.CH Jacques Monod, NephrologyFlersFrance
  6. 6.CH Robert Bisson, NephrologyLisieuxFrance
  7. 7.CHU de Caen Division of Medical InformaticsCaenFrance
  8. 8.CH Pasteur, NephrologyCherbourgFrance
  9. 9.CH Mémorial France Etats-Unis, NephrologySaint-LôFrance
  10. 10.Nephrology, CHU de CaenCaen CEDEX 9France

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