title: The changing landscape of home dialysis in the United States.
abstract: OBJECTIVE
  To discuss the changing landscape of home dialysis in the United States over the past decade, including recent research on clinical outcomes in patient undergoing peritoneal dialysis and home hemodialysis, and to describe the impact of recent payment reforms for patients with end-stage renal disease.
  
  
  RESULTS
  Accumulating evidence supports the conclusion that clinical outcomes for patients treated with peritoneal dialysis or home hemodialysis are as good as or better than for patients treated with conventional in-center hemodialysis. The recent implementation of the Medicare-expanded prospective payment system for the care of end-stage renal disease patients has resulted in substantial growth in the utilization of peritoneal dialysis in the United States. Utilization of home hemodialysis has also grown, but the contribution of the expanded prospective payment system to this growth is less certain.
  
  
  CONCLUSIONS
  Home dialysis, including peritoneal dialysis and home hemodialysis, represents an important alternative to in-center hemodialysis that is effective and patient-centered. Over the coming decade, the growth in the number of end-stage renal disease patient treated with home dialysis modalities should prompt further comparative and cost-effectiveness research, increased attention to racial and ethnic disparities, and investments in home dialysis education for both patients and providers.
  http://links.lww.com/CONH/A13.
authors.affiliation: Kidney Research Institute and Harborview Medical Center, University of Washington, Seattle, Washington, USA.
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Rivara
authors.forename: Rajnish
authors.initials: R
authors.lastname: Mehrotra
mesh_terms: D006437:Hemodialysis, Home / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D006278:Medicare / Q000639:trends; D010530:Peritoneal Dialysis / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends*; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000639:trends*; D011445:Prospective Payment System / Q000639:trends; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology