Home hemodialysis. Revival of a superior dialysis treatment.
BACKGROUND
Home hemodialysis is usually considered a superior therapy, whose decline is related to demographic, social, psychological and financial factors as well as to competition with renal transplantation and PD.


METHODS
A home hemodialysis program was started in November 1998 in the University of Torino, Italy (200-210 patients on dialysis). Its main features are the tailoring of dialysis schedules and the acceptance of patients with comorbidity. Nurses assist home sessions in case of short-term problems, while the training center ensures follow-up for long-term clinical and logistic problems.


RESULTS
The program started in November 1998 on a previous one (active from 1970 to 1998; 6 patients on treatment in November 1998). Since then, 25 more patients joined the program. Out of 31 patients followed since November 1998, 4 were grafted, 2 died, and 2 dropped out from training. In June 2001, 15 patients were on home hemodialysis, 8 on training. Dialysis schedules and controls are flexible and tailored; in June 2001, range of dialysis time was 1.20-5 h; sessions: 2-6; 8 patients were on thrice-weekly dialysis, 7 on daily dialysis; all patients reached target EKRc >10 ml/min (median 15, range 11-24 ml/min).


CONCLUSIONS
Tailored, flexible schedules allowed home hemodialysis in over 10% of our patients, confirming that there is still room for this treatment in our setting.
Piccoli
Giorgina Barbara
GB
Cattedra di Nefrologia, University of Turin, Corso Bramante 88, I-10126 Turin, Italy. gbpiccoli@hotmail.com
Bermond
Francesca
F
Mezza
Elisabetta
E
Quaglia
Marco
M
Pacitti
Alfonso
A
Jeantet
Alberto
A
Segoloni
Giuseppe Paolo
GP
D000328:Adult; D000368:Aged; D017028:Caregivers; D002408:Catheters, Indwelling; D015331:Cohort Studies; D005260:Female; D017048:Health Care Costs; D006437:Hemodialysis, Home / Q000191:economics / Q000379:methods / Q000451:nursing / Q000639:trends; D006801:Humans; D007558:Italy; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome