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Last Updated 10/12/14
 
   

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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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Industry Questions Grassley's Request To Hike Pay For Home Dialysis Training - Headline only from InsideHealthPolicy. com, a pay-for-view web site. Related article from Nephrology News & Issues. - October 9, 2014
Editor's note: Why don't we finally admit that the dialysis industry is like the antebellum American South.

Dialysis clinics are the plantations of the dialysis industry. They must be populated with enslaved patients in order to make the profits that Wall Street expects. The large for-profit dialysis providers are the plantation owners, pushing agendas and legislation to make them richer. Kidney Care Partners is the political body that justifies it all to the world.

Nephrologists and renal administrators are the overseers, getting their share of the profits. The complacent patient groups are the trustees, urging the enslaved to conform and to try to see the wise benevolence of their owners and overseers.

No owner, nephrologist, or dialysis professional would accept the care given to the vast majority of enslaved patients on these "plantations." 

Chronic dialysis care began just over 50 years ago.  The federal dialysis program that pays for most treatments began just over 40 years ago.  While everyone applauds the life sustaining potential of dialysis therapy, there is a general consensus that this specialty of nephrology has lagged far behind other fields of medicine in terms of reducing mortality and restoring patients to health. 

For whose benefit are we maintaining this system?

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September 2014 510(k) Clearances - Dialysis-related products cleared for marketing in the U.S. include:  - October 10, 2014

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The Financial Impact of Increasing Home-Based High Dose Hemodialysis and Peritoneal Dialysis - Provisional abstract and full-text article (22-page pdf) from BMC Nephrology - October 2, 2014

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Effect of Alternate Night Nocturnal Home Hemodialysis on Anemia Control in Patients with End-Stage Renal Disease - Early View Abstract from Hemodialysis International - September 23, 2014

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  WEB RESOURCES
blue ball Latest Scientific Journal Articles on Home and Daily Dialysis Continually Updated!
Home Dialysis Central web site
Nocturnal Home Haemodialysis web site
Home Dialyzors United web site
Current Issues of Home Dialysis Central Newsletter
Current Issue of At Home with AAKP an electronic newsletter produced and distributed by the American Association of Kidney Patients (AAKP)
Home At Last Newsletter from the NxStage web site
Home Hemodialysis Fact Sheet (pdf format requires Adobe Acrobat reader.) from the American Nephrology Nurses’ Association
PD and Home Hemo Coverage Maps from the Home Dialysis Central web site
Home Hemodialysis (pdf format requires Adobe Acrobat reader) from the National Kidney Foundation (NKF) web site
Home Hemodialysis: Helping Patients Lead a Healthier Life online seminar from the American Association of Kidney Patients (AAKP)
Home Hemodialysis from the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC)
Home Dialysis DVD from Home Dialysis Central web site
Home Dialysis Assessment Tool (pdf) from the Home Dialysis Central web site

Live healthier, better, longer with more frequent home hemodialysis an educational booklet that outlines the documented benefits and risks of home and more frequent home hemodialysis therapy from the NxStage web site

Book: Daily and Nocturnal Hemodialysis by Lindsay, Buoncristiani, Lockridge, Pierratos, and Ting © 2004

Book: Help, I Need Dialysis! How to have a good future with kidney disease by Dori Schatell, MS and Dr. John Agar © 2012

Nocturnal Home Hemodialysis - A First Person Account, Part I and Part II by Michael Williams
American Nephrology Nurses Association (ANNA web site) position on daily home hemodialysis

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!
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
Rubin Diaylsis Center
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
Daily, Home, Nocturnal Hemodialysis Discussion Forum - RenalWEB Discussion Forum
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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)
Statistical Analyses on dialysis patient hospitalization rates, morbidity, mortality, and more from Chronic Disease Research Group (CDRG)
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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