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Home dialysis-an international perspective
1Sheffield Kidney Institute Sheffield Teaching Hospitals NHS, Sheffield, UK.
NDT Plus
|May 8, 2015
Summary
Home dialysis use is declining globally despite evidence supporting patient self-management. Complex factors influence home dialysis adoption, with center-based hemodialysis remaining dominant, limiting patient choice in renal replacement therapy.
Area of Science:
- Nephrology and Renal Replacement Therapy
- Patient Self-Management and Health Outcomes
- Healthcare Systems and Policy
Background:
- Growing evidence links patient self-management to improved outcomes in chronic conditions.
- Despite self-management benefits, international trends show a decline in home dialysis utilization.
- Center-based hemodialysis remains the dominant form of renal replacement therapy globally.
Purpose of the Study:
- To explore international practice patterns and key drivers influencing home dialysis adoption.
- To identify barriers and facilitators impacting the use of home dialysis worldwide.
- To examine the role of patient information, shared decision-making, and patient involvement in care.
Main Methods:
- An opinion-based commentary synthesizing current knowledge on home dialysis.
- Analysis of practice patterns and drivers based on international data.
- Inclusion of data from sources such as the 2010 United States Renal Data System report.
Main Results:
- Drivers for home dialysis are multifaceted, involving patients, carers, healthcare teams, systems, geography, and culture.
- Local initiatives and champions can positively impact home dialysis rates, but significant barriers persist.
- Enhanced patient information systems, shared decision-making, and patient engagement show potential for driving change.
Conclusions:
- Center-based hemodialysis continues to dominate international renal replacement therapy.
- This dominance suggests limited modality choice for many patients globally.
- Addressing barriers and promoting patient-centered approaches are crucial for increasing home dialysis options.
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