title: Home haemodialysis in Australia - is the wheel turning full circle?
abstract: In the mid 1970s, home haemodialysis accounted for nearly half of all patients on dialysis, both in Australia and elsewhere. The advent of both peritoneal dialysis (itself a home therapy) and satellite haemodialysis resulted in a gradual attrition in the use of home haemodialysis. Since 2000, the introduction of nocturnal home haemodialysis has begun to change this pattern in Australia, with a sharp growth in the uptake of home haemodialysis. Home haemodialysis, which enables longer hours and more frequent treatments than facility-based (hospital or satellite centre) dialysis, appears to offer improved patient outcomes in observational studies; randomised studies are necessary to confirm these findings. Home haemodialysis is also a cheaper form of therapy than facility-based dialysis. As newer, simpler and more user-friendly equipment is emerging that will make home haemodialysis even more accessible and attractive to the consumer, we believe that this trend toward a greater uptake of home haemodialysis should and will continue.
authors.affiliation: Geelong Hospital, Geelong, VIC, Australia. johna@barwonhealth.org.au
authors.forename: John W M
authors.initials: JW
authors.lastname: Agar
authors.forename: Carmel M
authors.initials: CM
authors.lastname: Hawley
authors.forename: Charles R P
authors.initials: CR
authors.lastname: George
authors.forename: Timothy H
authors.initials: TH
authors.lastname: Mathew
authors.forename: Stephen P
authors.initials: SP
authors.lastname: McDonald
authors.forename: Peter G
authors.initials: PG
authors.lastname: Kerr
mesh_terms: D001315:Australia; D003362:Cost-Benefit Analysis; D006437:Hemodialysis, Home / Q000191:economics / Q000379:methods / Q000401:mortality / Q000639:trends*; D006801:Humans; D016030:Kidney Transplantation; D015996:Survival Rate