Providing Hope and Support to Dialysis Patients

You are Not Alone

header photo

Workshop Held to Consider New Guidelines for Home Dialysis

With a globally increasing incidence of chronic kidney disease, the need for universal access to cost-effective renal replacement therapy treatment options across the world is needed, particularly in low- and middle-income countries where dialysis treatment options are currently limited and, in many cases, cost prohibitive.

Options for home
Home dialysis treatment options including peritoneal dialysis (PD) and home hemodialysis (HHD) are associated with increased patient satisfaction and autonomy and, in many cases, improved quality of life. In particular, PD may be delivered at lower costs with less infrastructural requirements compared to center-based hemodialysis. 
The global COVID-19 pandemic has underscored and brought to light the need for developing and accelerating home-based care across all areas of medicine. The potential advantages of home-based dialysis care are increasingly important given that home patients are able to minimize health-care facility visits, reduce dialysis delivery in congregate settings and better adhere to social distancing measures. 
Despite the significant benefits of home-based dialysis therapies, use of these therapies remains variable across countries.

Barriers to home dialysis
From a patient and caregiver perspective, many barriers exist to choosing and performing dialysis at home. Evidence-based strategies for patient and care partner education regarding treatment options are needed including the role of peer to peer education.
Challenges in use of home dialysis need to be addressed in vulnerable and historically underrepresented populations and in areas where socioeconomic and health literacy challenges need to be considered. The degree to which barriers to home dialysis can be overcome may also depend on the presence of assisted home dialysis programs which have been successful across many jurisdictions in addressing physical and cognitive barriers to home dialysis self-care. 
Taken together, the controversies conference will support an in-depth exploration of the following four key questions that are fundamental to address rationale for, and strategies to facilitate increased global use of home dialysis:

  1. What is the evidence base to support increased use of home dialysis, focusing on clinical and patient-reported outcomes? 
  2. What are barriers at the facility level that impact home dialysis utilization and how can these be addressed?
  3. What are individual-level challenges that individuals and care partners face that impact choice and use of home dialysis therapies?
  4. What are the financial and policy considerations that impact global differences in rates of home dialysis utilization? 

Edited for content. To read the entire article, visit