Analysis and outcome of 1063 patients trained for home hemodialysis

Between 1967 and 1973, 12 home dialysis training centers (HDTC), under contract to the health Resource Administration, Department of Health, Education, and Welfare, reported training 1063 patients. Mean training time was 69 days; mean patient age was 40 yr with a range of 12 to 75 yr. Survival rates were 87% at one year, 74% at two years, 62% at three years, 54% at four years and 52% at five years. Male to female ratio was 3.2; there was no significant survival difference between sexes. Patients under 50 yr of age had significantly greater survival than did patients 50 yr and older. A "good" health status classification, defined by activity tolerance, signs and symptoms at the beginning of home dialysis, was associated with more favorable survival than were lower health ratings. Patients with glomerulonephritis, pyelonephritis and polycystic disease had better survival than did patients with diabetic, hypertensive and other renal disease etiologies. Although 51% of the patients lived 50 to 400 or more miles from the HDTC, their survival was not different from patients living less than 50 miles from the HDTC. Survival rates for patients with less than ten years of education were not significantly different from those with formal education as high as the university graduate level. Forty-seven percent of the patients were restored to full activity. These survival results are comparable with those reported for other modes of dialysis and transplantation and indicate that home dialysis is an acceptable form of therapy for a variety of patients.