Is home hemodialysis safe?
There is a paucity of literature available on the rate of adverse events and technical complications associated with HHD. Adverse events associated with conventional hemodialysis are also present with HHD. Life-threatening emergencies like exsanguination and air embolism are rare. Other complications like access-related infections, hemolysis, hemodynamic instability associated with aggressive ultrafiltration, or dialysate leak and acute electrolyte derangements associated with treatments are more common. Nonetheless, HHD is safe. One retrospective multicenter study out of Canada found that among 190 HHD patients, life-threatening adverse events occurred at a rate of 0.060 per 1000 treatments. Another study out of New Zealand and Australia found after comparing HHD pts to conventional in-center dialysis the relative risk of death from angioaccess bleeding or infection was 0.27 (0.20 to 0.37). Effective training/retraining, routine evaluation of access stability, wet sensors, and machine alarms, along with other safety measures, are utilized to reduce adverse events associated with HHD.