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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

"Everything You Wanted to Know about Home Dialysis-the Australian Way" - Posting from Home Dialyzors United. - May 4, 2013

Free, Full-Text Articles from Kidney International - May 2013
• Effect of Frequent Hemodialysis on Residual Kidney Function
• Commentary for 'Effect of Frequent Hemodialysis on Residual Kidney Function': Frequent Hemodialysis Network (FHN) Trials

NxStage Announces FDA Clearance for New High Flow Capabilities with NxStage System One - Press release. - April 30, 2013

Home and Health Devices Controlled by Apps on the Rise - Article from Reuters. - April 22, 2013

Does More Frequent Hemodialysis Impact Mental Health? - Posting from the eAJKD blog. - April 18, 2013

Thrice Weekly Nocturnal Hemodialysis: the Overlooked Alternative to Improve Patient Outcomes - Advance Access abstract from NDT. - April 17, 2013

Dialysate Calcium Concentration and Mineral Metabolism in Long and Long-Frequent Hemodialysis: A Systematic Review and Meta-analysis for a Canadian Society of Nephrology Clinical Practice Guideline - Articles in Press Abstract from American Journal of Kidney Diseases - April 15, 2013

Psychological Factors Associated with Successful Outcomes in Home Hemodialysis - Accepted Article abstract from Nephrology. - April 10, 2013

The Role of Short Daily Hemodialysis in the Control of Hyperphosphatemia, Secondary Hyperparathyroidism and Anemia - Online First Abstract from International Urology and Nephrology - April 2013
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  WEB RESOURCES
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
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
At Home With Dialysis - patient web site about her experiences on home dialysis.
American Nephrology Nurses Association (ANNA web site) position on daily home hemodialysis
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 Table of Contents
 

Clinical Practice Guidelines and Clinical Practice Recommendations 2008 Updates
 

I. Measurement of Hemodialysis Adequacy (Guidelines 1-3)
 

II. Hemodialysis Dose (Guidelines 4-6)
 

III. Blood Urea Nitrogen (BUN) Sampling (Guidelines 7-9)
 

V. Hemodialysis Dose Troubleshooting (Guideline 14)
 

VI. Maximizing Patient Compliance to the Hemodialysis Prescription (Guidelines 15-16)
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)
Hemodialysis Advisory Information from the American Association of Kidney Patients (AAKP) web site
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
October 3-4, 2013 - Sixth Annual Manchester Symposium on Home Dialysis, The Lowry Hotel, Manchester, UK - symposium page (word doc), Central Manchester University Hospitals NHS Foundation Trust web site, +0161 276 4411, e-mail
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  INPUT / SUGGESTIONS
E-mail to RenalWEB on the Hemodialysis Adequacy Topic
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