The resurgence of home dialysis therapies.
A recent resurgence of interest in home dialysis treatment is being driven by several factors, including (1) improved clinical outcomes associated with more frequent hemodialysis possible with home therapy; (2) patient preference for and greater convenience of home treatments; (3) lower treatment cost; (4) reduced staffing requirements; and (5) the availability of equipment specifically designed for self-care/home therapy. An important factor has been the recognition that the outcomes of peritoneal dialysis are similar to those of conventional in-center hemodialysis, and the advantages to the patient of utilizing different modalities during their dialysis "lifetime." Additionally, regional home-dialysis programs that offer the full continuum of home therapies and provide comprehensive patient education and clinical support have been developed as a model for reinvigorating home therapies. A shift away from the current model with all too frequent late referral of patients for in-center treatment to a new model characterized by early intervention and home-based dialysis therapies will improve outcomes, while more effectively handling the growing population of patients requiring maintenance renal replacement therapy.
Moran
John
J
WellBound Inc., Mountain View, CA 94041, USA. moranj@satellitehealth.com
D005260:Female; D006437:Hemodialysis, Home / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000458:organization & administration; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D017060:Patient Satisfaction; D018579:Patient Selection; D010530:Peritoneal Dialysis / Q000379:methods / Q000706:statistics & numerical data; D011788:Quality of Life; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome