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Home dialysis: there's no place like home
Jeffrey D Wallach1, Juan A Medaura2, Leonard Stern3
1Post-Acute Care Dialysis, New York City Health and Hospitals Corporation New York, New York; Milwaukee Nephrologists, SC, Milwaukee, Wisconsin.
Current Opinion in Nephrology and Hypertension
|December 17, 2024
Summary
Home dialysis offers benefits for end-stage kidney disease (ESKD) patients. This review addresses barriers and promotes patient-centered choices for home dialysis, aiming to increase its use.
Area of Science:
- Nephrology
- Renal Replacement Therapy
- Patient Care
Background:
- End-stage kidney disease (ESKD) prevalence has surged, accompanied by a decline in home dialysis use and a rise in in-center hemodialysis in the US.
- There's a growing emphasis on enhancing access to home dialysis modalities for ESKD patients.
- This review addresses the need for updated clinical data and guidelines to support home dialysis.
Purpose of the Study:
- To update kidney care providers on clinical outcomes and new guidelines for home dialysis.
- To promote patient-centered choices in dialysis modality selection.
- To identify and address barriers hindering home dialysis adoption and sustained use.
Main Methods:
- Review of recent literature on home dialysis.
- Examination of evolving practice guidelines for prescribing home dialysis.
- Analysis of patient and caregiver perspectives on treatment goals.
Main Results:
- Exploration of newer care models designed to boost home dialysis for incident ESKD patients.
- Evaluation of assisted home dialysis and home dialysis within nursing home settings.
- Assessment of the influence of novel payment structures incentivizing home dialysis providers.
Conclusions:
- Empowering dialysis providers with confidence to advocate for home dialysis benefits.
- Providing insights into the future trajectory of home dialysis.
- Transforming healthcare professionals into impartial advocates for patients considering home dialysis.
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