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Last Updated 03/12/17
 
   

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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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NxStage Medical Announces CE Mark for its NxGen Hemodialysis System - March 2, 2017

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Home Hemodialysis: a Comprehensive Review of Patient Centered and Economic Considerations - Abstract and link to full-text PDF from ClinicoEconomics and Outcomes Research. - February 16, 2017

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Effect of Nocturnal Hemodialysis versus Conventional Hemodialysis on End-Stage Renal Disease: A Meta-Analysis and Systematic Review - Free, Open Access Article from PLOS ONE. - February 14, 2017

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Self-Care on Hemodialysis: Behaviors With the Arteriovenous Fistula - Early View Abstract from Therapeutic Apheresis and Dialysis. - February 14, 2017

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Telehealth in the Delivery of Home Dialysis Care: Catching up With Technology - Telehealth in Nephrology —  Free Jan. 2017 Issue of Advances in Chronic Kidney Disease. - January 2017

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Low Versus High Dialysate Calcium Concentration in Alternate Night Nocturnal Hemodialysis: a Randomized Controlled Trial - Free Issue (January 2017) of Hemodialysis International - January 2017

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Persistent Variation in Medicare Payment Authorization for Home Hemodialysis Treatments - Early View abstract from Health Services Research. - January 19, 2017

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Patients Receiving Frequent Hemodialysis Have Better Health-Related Quality of Life Compared to Patients Receiving Conventional Hemodialysis - Free, full-text article from Kidney International. Also see this recent supplemental issue on intensive hemodialysis from AJKD. - January 14, 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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