Home hemodialysis (HHD)
Home hemodialysis is a kidney replacement modality for patients with end-stage kidney disease (ESKD) that can be performed safely in the patient’s home environment.
Assistance of a trained caregiver or qualified hemodialysis nurse is a requirement.
The frequency of treatment for HHD can vary per individual patient. HHD can be performed as conventional HHD, with treatments 3 days a week for 3 to 4 hours or longer each time.
It can also be performed as short daily HHD, occurring 5 to 7 times a week for shorter duration.
Lastly, it can be performed overnight as nocturnal NHHD where treatments normally last 6 to 8 hours.
4 Interesting Facts of Home hemodialysis
1. HHD is usually prescribed as more frequent and shorter dialysis seasons compared to conventional in-center dialysis. As such, HHD has been shown to improve several important surrogate outcomes like phosphorus and BP control. It likely is associated with improved patient survival as well.
2. HHD is convenient, allows for greater patient autonomy, and provides a portable platform to perform kidney replacement therapy.
3. HHD is a safe dialysis modality that has multiple safety mechanisms incorporated into the machine and patient training. This leads to life-threatening adverse events being very rare occurrences.
4. Key barriers to HHD include patients’ fears, anxiety toward managing their dialysis outside of a medicalized facility, and the dialysis provider’s lack of familiarity with the modality.