Modalities and prescribing strategies in intensive home hemodialysis: a narrative review

Over the past decades, evidence on the benefits of intensive hemodialysis, more frequent and longer comparing to conventional hemodialysis, has emerged. The home environment is an ideal setting to perform intensive hemodialysis without the reliance on organizational and structural needs. The observed benefits of frequent hemodialysis have resulted in a rise in prevalent intensive home hemodialysis patients around the world. A successful home hemodialysis program requires a well-structured predialysis education program with focus on home dialysis and a dedicated multidisciplinary team with knowledge about the specifics of home hemodialysis and with a holistic approach to provide optimal care. In this narrative review, we describe different modalities of home hemodialysis and dialysis prescription specifics of intensive nocturnal hemodialysis, the modality with overall best outcomes.