Intensified home hemodialysis: clinical benefits, risks and target populations

Intensive home hemodialysis (IHHD) has emerged as an alternate treatment option for patients with end-stage renal disease and has several established and potential clinical benefits. These clinical advantages need to be tempered against a growing appreciation of the risks of IHHD, including a potentially higher rate of vascular access interventions. Identifying who might be an eligible and optimal candidate for IHHD is paramount to its expansion as an important form of renal replacement therapy. In the following review, we will provide a working definition of IHHD, discuss its major clinical benefits/risks and identify potential target populations to whom this therapy can be provided.