Home HD has 20% lower all-cause mortality than PD

In a new study that matched 4,201 new home HD patients in the USRDS database to new PD patients, the risk of all-cause mortality was 20% lower with home HD. In addition, there was an 8% lower risk of hospitalization, and a 37% lower risk of technique failure.

Read the abstract » | (added 2015-09-11)

Tags: Home dialysis

Low Molecular Weight Heparins for Nocturnal HD

A small Netherlands study of in-center nocturnal HD suggests that two divided doses may work best for low molecular weight heparins dalteparin and nadroparin. Careful dosing is needed to obtain the right level of anticoagulation and avoid overcorrection. Dalteparin required higher doses than nadroparin.

Read the abstract » | (added 2015-08-08)

Tags: Home dialysis

PD Preserves Patient Jobs Compared to Standard In-center HD

In Japan, at least (and these questions are rarely looked at in the US), a study of social functioning on PD vs. standard in-center HD found an advantage for PD. Among 179 patients (102 PD and 77 HD), the odds of becoming unemployed after treatment were 5.02 fold lower with PD.

Read the abstract » | (added 2015-08-08)

Tags: Home dialysis

Outcomes of “integrated home dialysis” (PD then home HD)

What happens to people after PD fails—and why not plan to get them home on HD? Researchers in Australia and New Zealand looked at this model using ANZDATA registry data. Those treated with PD only (n=168) had the highest risk of technique failure and death, while those who did only home HD or who transitioned from PD to home HD fared much better.

Read the abstract » | (added 2015-07-08)

Tags: Home dialysis

Status Report: Home HD in Japan

While just 0.1% of all Japanese people on dialysis use home HD, this number has been growing quickly. Work groups of the Japanese Society for Home Hemodialysis have been set up to start a patient registry and advise on supply and wastes and the cost burden for those who self-pay. Further challenges will include recruitment, education, a business model, and more.

Read the abstract » | (added 2015-06-10)

Tags: Home dialysis

New index more accurate than Kt/V for PD “adequacy”

It’s no secret that we at Home Dialysis Central are not fans of Kt/V for HD (or the concept of “adequacy”). A new European study suggests that Kt/V is not useful for PD, either (because it does not account for protein intake), and has tested a substitute index that works better.

Read the abstract » | (added 2015-05-09)

Tags: Home dialysis

Home hemodialysis needs you! Special Kidney International supplement.

A special supplement of Kidney International focuses on how to implement home hemodialysis, from policies and procedures to equipment, recruitment, safety, prescription, staffing, and more—from global experts. Don't miss it!

Read the abstract » | (added 2015-05-09)

Tags: Home dialysis

Nocturnal home HD catheter sepsis rates similar to in-center

When 63 nocturnal home HD patients with catheters were matched 1:20 with standard in-center HD patients, both groups had similar rates of sepsis. The catheters lasted about the same length of time.

Read the abstract » | (added 2015-02-10)

Tags: Home dialysis

How patients and care partners feel about home HD

A review of 24 qualitative studies of home HD patients and care partners found five themes: feeling vulnerable, fear of being alone, concerns about family burden, opportunity to thrive, and appreciating medical responsiveness. Starting home HD seemed to be an especially anxious time. Acknowledging these themes and offering reassurance may help more people succeed on home HD.

Read the abstract » | (added 2015-02-10)

Tags: Home dialysis

Should Home Dialysis Be Mandatory for Suitable Patients?

Considering improved survival, dramatically better quality of life, and reduced cost, should home dialysis be the default option?

Read the abstract » | (added 2015-01-08)

Tags: Home dialysis