Screening and supportive techniques for home dialysis in the treatment of renal failure

Patients with end-stage renal disease are being kept alive by dialysis treatment which may be provided either in an institution or in the patient's home. However, medical advancements have outstripped the ability of the treatment team to insure the quality of life for these long-term patients. Although the predominant pattern of care continues to be the hospital- or institution-based unit, an attempt is being made by both patients and physicians to make home dialysis a more viable alternative. There are two major barriers to the large-scale effectiveness of treatment by home dialysis: 1) lack of criteria for the selection of candidates, and 2) lack of a continuing supportive service system. Home care requires a total understanding of the psychosocial functioning of the patient and the family.