Home Hemodialysis Practices and Patient Outcomes
Summary
Home haemodialysis has emerged as a vital alternative to in-centre treatment, offering patients greater autonomy, improved physiological stability and potential survival benefits. Advances in portable dialysis machines, remote monitoring systems and patient education have facilitated safe delivery in the home environment. Protocols vary in frequency and duration, ranging from traditional thrice-weekly sessions to short-daily or nocturnal regimens, each with distinct impacts on solute clearance, fluid management and cardiovascular stress. Clinical outcomes extend beyond urea removal metrics to encompass bone mineral density, muscle strength, inflammatory markers and quality of life. Economic analyses highlight potential cost savings through reduced hospital attendance, yet upfront training and equipment expenses require policy support. Patient engagement and shared decision-making are central to modality selection, with tailored training programmes ensuring competence and confidence. Globally, uptake is influenced by healthcare infrastructure, reimbursement frameworks and socio-economic factors, prompting international initiatives to harmonise guidelines and expand access.
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Home Hemodialysis Practices and Patient Outcomes publication trend
The graph below shows the total number of articles in home hemodialysis practices and patient outcomes across all publications each year (not limited to Nature Index journals).
Technical terms
Home haemodialysis: A modality of renal replacement therapy in which patients perform blood filtration treatments in their own residence rather than in a clinical setting.
Short-daily haemodialysis (SDH): A regimen involving haemodialysis sessions of shorter duration but increased frequency, usually five to six times per week, designed to improve metabolic control and patient well-being.
Kt/V: A dimensionless index of dialysis adequacy calculated by the product of dialyser clearance (K) and treatment time (t) divided by patient volume of distribution of urea (V).
Quality-adjusted life-year (QALY): A measure combining length of life with quality of life to assess the value gained by health interventions in terms of patient-reported outcomes.
Markov model: A mathematical framework for simulating transitions between health states over time to evaluate long-term costs and outcomes of medical interventions.
References
- Home-Based Dialysis: A Primer for the Internist. Annual Review of Medicine (2023).
- Exploring the impact of short daily haemodialysis on muscle strength and bone health in end‐stage kidney disease patients. Journal of Cachexia Sarcopenia and Muscle (2024).
- Value of an Integrated Home Dialysis Model in the United Kingdom: A Cost-Effectiveness Analysis. Value in Health (2023).
- Remote Monitoring Systems for Chronic Patients on Home Hemodialysis: Field Test of a Copresence-Enhanced Design. JMIR Human Factors (2017).
- Expanding Utilization of Home Dialysis: An Action Agenda From the First International Home Dialysis Roundtable. Kidney Medicine (2021).
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