Choosing Home Hemodialysis: A Critical Review of Patient Outcomes

Blood Purification
Brent MillerRobert J Kossmann

Abstract

Home hemodialysis (HHD) has been associated with improved clinical outcomes vs. in-center HD (ICHD). The prevalence of HHD in the United States is still very low at 1.8%. This critical review compares HHD and ICHD outcomes for survival, hospitalization, cardiovascular (CV), nutrition, and quality of life (QoL). Of 545 publications identified, 44 were not selected after applying exclusion criteria. A systematic review of the identified publications was conducted to compare HHD to ICHD outcomes for survival, hospitalization, CV outcomes, nutrition, and QoL. Regarding mortality, 10 of 13 trials reported 13-52% reduction; three trials found no differences. According to 6 studies, blood pressure and left ventricular size measurements were generally lower in HHD patients compared to similar measurements in ICHD patients. Regarding nutritional status, conflicting results were reported (8 studies); some found improved muscle mass, total protein, and body mass index in HHD vs. ICHD patients, while others found no significant differences. There were no significant differences in the rate of hospitalization between HHD and ICHD in the 6 articles reviewed. Seven studies on QoL demonstrated positive trends in HHD vs. ICHD populations. Despi...Continue Reading

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Citations

Apr 11, 2019·Hemodialysis International·Oksana HarasemiwPaul Komenda
Jul 24, 2020·Expert Review of Medical Devices·Clive BuckberryJohn E Milad
Dec 12, 2020·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Emily K YeungPeter G Kerr
Apr 30, 2021·Néphrologie & thérapeutique·Sandip MitraLeonard Ebah

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