| Abstract: |
In this commentary, the author explains his support of home hemodialysis (HD) as a vital option for patients who need renal replacement therapy. The author notes that, to increase dialysis dose in a practical manner, there need to be radical changes in how or where dialysis is provided. The vast majority of patients still receive in-center HD three times per week, and a decreasing number of patients do peritoneal dialysis (PD) at home. The author stresses that by removing the schedule limitations of traditional dialysis, therapy can be more like the naturally functioning kidney, improving patient well-being and quality of life. The author reviews the changes over the years in the numbers of patients using home dialysis; summarizes the advantages of more frequent dialysis, including blood pressure control, volume control, phosphorus management, quality of life, reduced hospitalization, and increased survival; and briefly considers the issues that need to be addressed before home hemodialysis can truly experience a resurgence, including increased simplicity and patient support, physician awareness, and reimbursement. 1 figure. 1 table. 6 references. |