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Home hemodialysis in Australia: current perspective
Peter G Kerr1, Kevan R Polkinghorne, Stephen P McDonald
1Monash Medical Centre and Monash University, Clayton, Victoria, Australia. peter.kerr@med.monash.edu.au
Hemodialysis International. International Symposium on Home Hemodialysis
|July 22, 2008
Summary
Home hemodialysis in Australia is increasing, driven by nocturnal home hemodialysis (HD). Nocturnal HD offers survival advantages, making it a key focus for Australian dialysis patients.
Area of Science:
- Nephrology
- Renal Replacement Therapy
Background:
- Home hemodialysis (HD) constitutes 11% of Australia's dialysis population.
- Despite a historical decline, the absolute number of home HD patients has risen since 2001.
- Nocturnal HD is the primary driver of this resurgence, comprising over 30% of all home HD.
Purpose of the Study:
- To analyze trends in home hemodialysis in Australia.
- To investigate the impact of nocturnal home hemodialysis on patient outcomes.
- To understand the current practices and patient support for home HD in Australia.
Main Methods:
- Analysis of Australian dialysis population data.
- Review of home hemodialysis practices, including machine types and monitoring.
- Examination of patient self-care aspects like self-needling and partner support.
Main Results:
- Nocturnal HD, often performed on alternate days or 5-6 times weekly, is increasingly common.
- Short-daily HD remains uncommon in Australia.
- ANZDATA Registry data indicates survival benefits for alternate-day and longer-duration ( >18 hours/week) nocturnal HD compared to conventional schedules.
Conclusions:
- Nocturnal home hemodialysis is a significant and growing modality in Australia.
- Survival advantages observed in nocturnal HD support its continued adoption.
- Current Australian home HD practices often involve simple machines and patient self-management.
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