Combes, Gill

Holvoet, Els

Van Biesen, Wim

Van Humbeeck, Liesbeth

English

Ghent University Academic Bibliography

anticoagulation that was either suspended 8-12 days pre PRB or replaced by lowmolecular weight heparin (not given one day pre procedure). PRB complications: 30,4%minor asymptomatic complications detected by routine ultrasound and 4,6% hadmajorcomplications (surgical or radiological intervention and/or blood products requirement).Risk factors: pre PRB hemoglobin levels<10 g/dL and diastolic blood pressure>90mmHgwere significant risk factors. Abnormal PFA 100wasn’t statistically significant.DDAVP complications:Mean sodiumdecline was 0,963,4mEq/L. 2 patients hadhyponatremia without neurological symptoms: one dropped from 128 to 124mEq/L andanother one had a sodiumdecrease of 12mEq in 24 hours.None of the patients had acardiovascular event after dosage (up to onemonth). Table 1:N = 65 RangeAGE 556 13,3 30-84GENDER 43 males (66%) 22females (34%)KIDNEY TYPE 36 native (55,4%)GLOMERULI Mean 10,74Median 10 0-41PASSES 1 = 22 (34%)2 = 36 (55%)3 = 7 (11%)NEEDLE 14G = 11 (17%)16G = 54 (83%)PLATELET/mm3 201.049,236 71.110,142 75.3 – 413 x103HB PRE (g/dL) 116 2,2 8,1-17HB POST (g/dL) 10,56 2,2 2,5-16,1GFR (MDRD4, ml/min) 27,256 22,28 2,1-102BPs pre(mmHg) 143,666 32,8 100-212BPd pre(mmHg) 81,806 9,5 60-99Sodium pre (mEq/L) 138,126 3,69 128-145Sodium post (mEq/L) 136,626 3,98 124-144Hb: haemoglobin; GFR: glomerular filtration rate; BPs: systolic blood pressure;BPd: diastolic blood pressure.CONCLUSIONS: Single dose DDAVP pre PRB is safe and can be used in patients withhigher risk of hemorrhagic complications, such as uremia.SP097 THE ACUTE USE OF VELTASSA (PATIROMER) IN A TERTIARYRENAL UNITMax Wills1, Amin Oomatia1, Jonathan Falconer1, Chi Tse1, Niamh Kelly1,Kieran Mccafferty11Royal London Hospital, London, United KingdomINTRODUCTION:Veltassa is a novel potassium binder that has recently been licensedto treat chronic hyperkalaemia. Its use as an acute treatment for hyperkalaemia or indialysis patients as a bridgingmeasure is unreported. Following its recent addition toour unit’s formulary for acute treatment at 8.4g OD, we share our experience of thedrug, and its use in treating hyperkalaemia and for bridging in patients on dialysiswhilst access is being (re-)established.METHODS: Each use of Veltassa is registered in our unit with patient demographicsfor audit and clinical governance purposes. A list of patients given the drug over fourmonths was collated and reviews of patient notes were then performed. Demographic,medical and biochemical data was recorded, as was episodic information andindication for the use of the drug.RESULTS: 120 patient episodes were identified, of which 15 were excluded due toinsufficient available data. Baseline demographics of the cohort of 105 patients: Themean age of the cohort was 57 years, with 55% beingmale. The prevalence of diabeteswas 47%, hypertension 57%. 49% of patients were undergoing haemodialysis, 8%peritoneal dialysis, 18% had a renal transplant, 12%were pre-dialysis and 13% had anAKI. In total 181 doses of Veltassa were administered (68 x1 doses, 18 x 2 doses, 10 x 3doses, 4 x 4 doses, 5 x =/>5 doses). Of the 105 patient episodes, there were no reports ofadverse events to Veltassa other than one discontinuation due to nausea. The outcomesof Veltassa use are given in the table below.Furthermore, of the 44 patients in total that needed repair or re-establishment ofdefinitive dialysis access, 11 (25%) were sent home and subsequently brought back toambulatory services to have their procedure done the next day, thus avoiding hospitaladmission.CONCLUSIONS:Our experience suggests that Veltassa is a well-tolerated agent andhas allowed for safe management of both dialysis and non-dialysis patients. Given ourexperience is a retro-spective review of real world use, it is not possible to say thatachieved outcomes were due specifically to Veltassa. In many instances otherpotassium lowering treatments were also given (e.g. insulin/dextrose) whilst in othercases the desired outcome may still have been achieved without Veltassa or even anytreatment. However, our experience suggests that Veltassa has a role for acute use inrenal patients, to safely delay/reduce the number of temporary dialysis line insertionsand unscheduled dialysis sessions in a tertiary renal unit.SP098 PATEIENTS’ EXPERIENCES OF TRANSITIONING FROM HOMEBASED TO IN CENTRE DIALYSIS: A QUALITATIVE STUDYEls Holvoet1, Wim Van Biesen1, Gill Combes2, Liesbeth Van Humbeeck11Ghent University Hospital, Ghent, Belgium and 2University of Birmingham,Birmingham, United KingdomINTRODUCTION: Although transitioning between RRTmodalities is common, dataon it are scarce. INTEGRATED is an international consortium aiming at improvedunderstanding of quantitative and qualitative aspects of transitioning.We aimed atexploring the experience of patients transitioning from a home based to an in-centermodality using a qualitative inductive approach.METHODS: Patients who transitioned RRTmodality were purposively selected. Semi-structured interviews were performed by one female researcher, recorded andtranscribed verbatim. Data analysis was performed consistent with Charmaz’constructivist approach of grounded theory and supported by NVivo10 (QSRInternational).RESULTS: 14 patients (78 %male, average age of 60.5 years (range: 27-84))participated. The conditions of the transitioning process impacted the participants’experience, resulting in divergent experiences and associated emotions. Not allparticipants experienced a loss of control due to the therapy-related changes (paradoxof control). Some felt tied down and having lost independence, whereas othersregained control as they felt relieved from responsibility. Whether patients experiencednot of this paradox of control was related to the patient having (1) experienced a fit ofHDwith their personal life-style, (2) a frame of reference, (3) a certain level of carerequirement, (4) insight in the underlying reasons for transitioning, and (5) trust in thehealth care providers. Appreciation of self-esteem, fear for the unknown and the futurewere however common themes.CONCLUSIONS:Combined with the collective perspective that preparation andinitiation of in- center dialysis therapy is emotionally fraught, care teams need to offerample opportunities to elicit patient’s knowledge and fears, dispel myths and forgeconnections with other patients. A visit to the dialysis unit can alleviate anxiety.Interventions that facilitate a sense of control need to be grounded in the meaning thedisorder has for the person and its impact on their sense of self.SP099 COMPLICATIONS AND RISKS OF PERCUTANEOUS RENALBIOPSYLada Trajceska1, Gjulshen Selim1, Irena Rambabova Busletik1,Aleksandar Sikole1, Galina Severova1, Igor Nikolov1, Pavlina Vidimliska Dzekova1,Goce Spasovski1, Vesna Ristovska1, Ladislava Grcevska11University Clinic of nephrology, Skopje, Republic of MacedoniaINTRODUCTION: Biopsy is performed in native and transplant kidneys and isgenerally considered as a safe procedure. In this study we evaluated the renal biopsycomplications and bleeding risk factors in one nephrology facility.METHODS:We conducted a three-year retrospective study on patients whounderwent renal biopsy between January 2014 until December 2016. Strict writtenbiopsy protocol was followed. Clinical and laboratory data were obtained frommedicalhistories. Complications were categorized as minor and major according to the need ofblood transfusions. Minor complications included macrohematuria and/or hematomadoi:10.1093/ndt/gfz103 | i395Nephrology Dialysis Transplantation AbstractsDownloaded from https://academic.oup.com/ndt/article-abstract/34/Supplement_1/gfz103.SP098/5515199 by Ghent University user on 06 January 2020

Patients' experiences of transitioning from home based to in centre dialysis : a qualitative study

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Patients' experiences of transitioning from home based to in centre dialysis : a qualitative study

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