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Last Updated 05/21/17
 
   

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The benefits of daily hemodialysis treatments seem obvious. Daily treatments more closely resemble normal kidney function than three-times-a-week treatments. It also means fewer dietary and fluid restrictions as well as fewer medications. Patient testimonials about the benefits of daily treatments are abundant.

Medicare payment policy, also known as the composite rate, is based on three-times-a-week dialysis. This is, at first glance, less expensive for the government than daily treatments. Evidence is building, however, that daily treatments may result in overall lower healthcare costs for end-stage renal disease patients by reducing hospitalizations and lowering overall drug costs.

The most expensive cost component of a hemodialysis treatment is the patient-care (nursing) labor. This can be greatly reduced by performing hemodialysis treatments in the home. A new generation of home hemodialysis machines is currently under development that greatly simplifies their operation and reduces the burden on a home partner. The Internet also makes remote monitoring of the dialysis machines by trained professional staff affordable and convenient.

Warning:  Changes should never be made in a patient's treatment or care based solely on the information found here.  Every patient has unique healthcare concerns and considerations and all these factors must all be taken into account before any changes can be safely made.  All medical and therapeutic decisions must come from a qualified health care provider.  Read RenalWEB's Legal Disclaimer before proceeding.


  NEWS & LATEST ARTICLES
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Home-Based Care for Chronic Kidney Disease - Update on a Patient-Centered Outcomes Research Institute (PCORI-funded) project involving the Zuni tribe in New Mexico. - May 2017

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Home Dialysis in the Prospective Payment System Era - JASN Express abstract. - May 10, 2017

"The ESRD Prospective Payment System bundling, but not the training add-on, associated with substantial increases in home dialysis, which were identical for both Medicare and non-Medicare patients. These spill-over effects suggest that major payment changes in Medicare can affect all patients with ESRD."

Editor's note: Imagine what a substantial financial incentive to increase patient employment among working-age patients (e.g. extend the MSP-period for employed patients) could do for treatments, technology, and the system of care. And the needs of tax-paying citizens pull a lot of weight in Washington!
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NxStage Wins FDA Nod for Next Generation System One Hemodialysis System - Article from MassDevice. - May 10, 2017

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Fractures and Osteomalacia in a Patient Treated With Frequent Home Hemodialysis - Article in Press abstract from American Journal of Kidney Diseases. - May 9, 2017

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Case of Mycobacterium mucogenicum in Home Hemodialysis Patient - Early View abstract from Hemodialysis International. - May 9, 2017

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Medicare & Tips to Increase the Use of PD and Home Hemodialysis (HHD) - Posting from the KidneyViews blog. - April 26, 2017

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  WEB RESOURCES
blue ball Latest Scientific Journal Articles on Home and Daily Dialysis Continually Updated!
blue ball Home Dialysis Central web site
blue ball Nocturnal Home Haemodialysis web site
blue ball Home Dialyzors United web site
blue ball Current Issues of Home Dialysis Central Newsletter
blue ball Alliance for Home Dialysis web site
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Home Dialysis Toolkit - resource to assist facilities in meeting the requirements of the Conditions of Coverage from the Medical Advisory Council (MAC) of the Forum.

blue ball Home Hemodialysis Fact Sheet (pdf format requires Adobe Acrobat reader.) from the American Nephrology Nurses’ Association
blue ball Home Hemodialysis from the National Kidney Foundation (NKF) web site
blue ball Home Hemodialysis from the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC)
blue ball Home Dialysis DVD from Home Dialysis Central web site
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GUIDE, a Structured Predialysis Program That Increases the Use of Home Dialysis from Clinical Kidney Journal. - May 30, 2016

blue ball Home Dialysis Assessment Tool (pdf) from the Home Dialysis Central web site
blue ball Book: Daily and Nocturnal Hemodialysis by Lindsay, Buoncristiani, Lockridge, Pierratos, and Ting © 2004
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Book: Help, I Need Dialysis! How to have a good future with kidney disease by Dori Schatell, MS and Dr. John Agar © 2012

blue ball Nocturnal Home Hemodialysis - A First Person Account, Part I and Part II by Michael Williams
blue ball PD and Home Hemo Coverage Maps from the Home Dialysis Central web site
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Self-Cannulation - Video via Renal Fellow Network web site

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A Home Dialysis Slide Show—And Sign Up For A Meeting! from the NxStage web site

blue ball Search result for Nocturnal dialysis by Google Continually Updated!
blue ball Home Dialysis web sites by Yahoo! Continually Updated!
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  HOME AND NOCTURNAL DIALYSIS PROGRAMS
Find a home dialysis center in your area from the Home Dialysis Central web site
The following Frequently Asked Questions (FAQs) were prepared by the staff of the Nocturnal Home Hemodialysis (NHHD) program at the Humber River Regional Hospital in Toronto.
Lynchburg Nephrology (Virginia) has their Nightly Home Hemodialysis (NHHD) Program.
Rogosin Kidney Center of The Rogosin Institute is the first center in the New York City metropolitan area to offer patients nocturnal hemodialysis. This type of self care home dialysis offers patients independence and freedom for day time activities.

Four, well known, not-for-profit dialysis providers:

Northwest Kidney Centers
Satellite Healthcare
DCI

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  PUBMED SEARCHES (National Library of Medicine's MEDLINE Database)
daily dialysis AND hemodialysis Continually Updated!
home hemodialysis Continually Updated!
nocturnal AND dialysis Continually Updated!
MEDLINE / Pubmed Information from the National Library of Medicine
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  K/DOQI™ -  Kidney Disease Outcomes Quality Initiative
NKF-K/DOQI Clinical Practice Guidelines
 

 

Clinical Practice Guidelines and Clinical Practice Recommendations 2006 Updates
K/DOQI Home Page from the National Kidney Foundation web site
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  DISCUSSION FORUM
Care-Partners for Home Dialysis discussion page
Daily, Home, Nocturnal Hemodialysis Discussion Forum - RenalWEB Discussion Forum
Home Dialysis Central Face Book discussion page
Home Dialyzors United Face Book discussion page
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  RELATED TOPICS
Adequate Hemodialysis Therapy - topic page from RenalWEB
Hemodialysis Dose and Adequacy from NIDDK
Clinical Practice Guideline on Adequacy of Hemodialysis - a book available from the Renal Physicians Association web site
Consensus Statement: Mortality and Morbidity of Dialysis from the NIH Consensus Development Program (written in 1993 with 1998 update)
United States Renal Data System (USRDS) 
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  UPCOMING EVENTS
 
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  INPUT / SUGGESTIONS
E-mail to RenalWEB on the Hemodialysis Adequacy Topic
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