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Hemodialysis at Home Provides Better Outcomes

Convenience, cost, frequency contribute to decrease in mortality rates…

A report from American Society of Nephrology (ASN) Kidney Week 2014 showed that home dialysis therapies may help prolong the lives of patients with kidney failure when compared to hemodialysis treatments administered in medical centers.

It was shown that home dialysis therapies are considered more convenient and less expensive than those given in a medical center, but it is unclear whether all home therapies can prolong patients’ survival. Researchers led by Austin Stack, MD, MDDCh, FASN, analyzed national data to compare dialysis survival among 585,911 patients who initiated dialysis in the United States between 2005 and 2010.

Major findings showed that patients who were treated with peritoneal dialysis were about 10% less likely to die during the study period than patients treated with standard 3-times per week in-center hemodialysis. Those patients receiving high-frequency home hemodialysis delivered six times per week were 26% less likely to die during the study period than those receiving standard in-center hemodialysis. Patients receiving less frequent home hemodialysis (4 or 5 times per week) had mortality risks that were similar to those of patients receiving in-center hemodialysis. Lastly, patients receiving home hemodialysis at a frequency of 3 times per week were 47% more likely to die than patients receiving in-center hemodialysis.

Dr. Stack stated, “We suggest that a treatment approach that adopts a peritoneal dialysis first or frequent home hemodialysis first strategy should be considered for all suitable patients who develop end stage kidney disease. Such an approach may offer superior survival, better quality of life, and be cost effective for national health care systems.”

Practice Pearls:

  • Home hemodialysis has shown to benefit patients in kidney failure resulting in less mortality associated with higher frequency of at-home dialysis compared to in-center dialysis.
  • Patients that received peritoneal dialysis were about 10% less likely to dies during the study period than patients with standard 3x-week in-center hemodialysis.
  • Frequent home hemodialysis first strategy should be considered for all suitable patients who develop end stage renal disease.

A.Stack: American Society of Nephrology. “Home Dialysis May Be Better than in-Center Hemodialysis for Patients with Kidney Failure.” ASN Kidney Week 2014