Perspectives in home hemodialysis therapy

Currently, there is renewed interest in home hemodialysis. However, home hemodialysis is not for every patient--the majority will continue to need treatment away from their home in hospital or satellite units. Those who are capable of undertaking treatment at home should be strongly encouraged to do so. Treatment at home permits improved quality of life and rehabilitation, and is cost-effective. However, it needs nephrologists versed in the techniques and benefits of home hemodialysis as well as nursing staff capable of undertaking the training, underpinned by a well-functioning predialysis program geared towards identifying and recruiting patients suitable for home hemodialysis well before dialysis is required. This review explores the origins, decline and reawakened interest in this treatment modality, and discusses novel technological approaches to ease the patient's treatment burden.