Home Hemodialysis: Benefits, Risks, and Barriers

Area of Science:

• Nephrology
• Renal Replacement Therapy
• Dialysis Modalities

Background:

• Home hemodialysis (HHD) has been an option since the 1960s, enabling intensive dialysis schedules.
• Studies indicate HHD improves patient survival and quality of life compared to in-center hemodialysis.
• Potential complications include vascular access issues, infection, loss of kidney function, and increased patient/caregiver burden.

Purpose of the Study:

• To review the benefits and challenges of home hemodialysis.
• To identify barriers to HHD adoption in Japan.
• To explore strategies for overcoming these barriers.

Main Methods:

• Literature review of home hemodialysis benefits and risks.
• Analysis of HHD patient numbers in Japan (2014).
• Identification of perceived barriers to intensive HHD.

Main Results:

• HHD offers intensive dialysis options like nocturnal or short daily treatments.
• In Japan, HHD adoption was low (0.2% in 2014).
• Key barriers included lack of patient motivation, resistance to change, and fear of self-cannulation.

Conclusions:

• Despite potential complications, HHD offers significant advantages in survival and quality of life.
• Barriers to HHD can be mitigated through comprehensive patient and caregiver education, training, and support.
• Effective strategies include nurse-assisted cannulation, home visits, and respite care.