There's no place like home—for dialysis

Most patients with chronic kidney disease who undergo hemodialysis put up with a grueling treatment regimen that involves going into a clinic several days a week and sitting through a three-to-four hour dialysis session at each visit. Home hemodialysis is more accessible than ever, though, with the advent of newer systems that are easier for patients to learn, use, and maintain, according to a review appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN). The authors offer suggestions for how to overcome barriers and establish a successful home hemodialysis program.

"There is virtually no other disease that requires patients to make such considerable changes in their lifestyle as a diagnosis of end-stage and the need for dialysis therapy does," said Rajnish Mehrotra, MD (University of Washington, Seattle). "To ease the challenge associated with such a diagnosis, offering patients choice allows them to select a dialysis therapy that best fits into their lifestyle and their expectations."

Home hemodialysis is one type of dialysis therapy, but it is available to less than 2% of in the country. Home hemodialysis requires extensive patient training, , and infrastructure support to maintain a successful program. Also, reluctance to start such programs is widespread because many physicians do not have experience with home hemodialysis.

Bessie Young, MD (University of Washington, Seattle) worked with Dr. Mehrotra and others to provide an in-depth review to describe the benefits and barriers to home hemodialysis, focusing on patients, physicians, practices, and dialysis facilities.

Benefits of home hemodialysis include:

  • Potential for greater dialysis delivery (more frequent or overnight treatments)
  • Improved quality of life
  • Patient independence and employment potential
  • Greater ability to travel
  • 20%-50% less costly than in-center hemodialysis depending on the machine.

Barriers to home hemodialysis include:

  • Lack of patient awareness and education about home hemodialysis
  • Patients' perceptions, including fear of change and lack of self-confidence
  • Physicians' education about home hemodialysis
  • Machine complexity, which is now minimal with newer, easier-to-use systems
  • Inadequate payment to providers for home hemodialysis training.

"Home hemodialysis has been successfully used by thousands of patients and should be available to everyone on or initiating dialysis. It is a safe, efficient modality that allows patients the ability to increase their frequency of dialysis, which may provide a potential survival benefit," said Dr. Young.

More information: The article, entitled "How to Overcome Barriers and Establish a Successful Home HD Program," will appear online on October 4, 2012, doi: 10.2215/CJN.07080712

add to favorites email to friend print save as pdf

Related Stories

Snapshot of dialysis: Who's getting treated at home?

Feb 02, 2012

Home-based dialysis treatments are on the rise in both the developing and developed worlds, but developed countries appear to be turning to them less often, according to a study appearing in an upcoming issue of the Journal of ...

Recommended for you

ECOWAS trains health workers to fight Ebola

57 minutes ago

West Africa's regional bloc ECOWAS said on Sunday it will train 150 health workers this week to help tackle the deadly Ebola disease in the worst hit countries; Guinea, Liberia and Sierra Leone.

US looking past Ebola to prepare for next outbreak

10 hours ago

The next Ebola or the next SARS. Maybe even the next HIV. Even before the Ebola epidemic in West Africa is brought under control, U.S. public health officials are girding for the next health disaster.

Can robots help stop the Ebola outbreak?

19 hours ago

The US military has enlisted a new germ-killing weapon in the fight against Ebola—a four-wheeled robot that can disinfect a room in minutes with pulses of ultraviolet light.

New bird flu case in Germany

19 hours ago

A worrying new strain of bird flu has been observed for the first time in a wild bird in northern Germany, the agriculture ministry said Saturday.

Mali announces new Ebola case

Nov 22, 2014

Mali announced Saturday a new case of Ebola in a man who is fighting for his life in an intensive care unit in the capital Bamako.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.