Got the Kidneys Under Control

Kidney problems in patients needing hemodialysis can be helped through home treatment

(RxWiki News) The lives of patients with kidney problems oftentimes revolve around their treatments, especially for those having to travel to get the care they need.

A recently published study looks into a therapy that could be done at home to help patients have more control over their lives.

By doing home hemodialysis, which is one kind of dialysis therapy, patients can move more freely, travel and their quality of life increases.

"Consider being trained in home hemodialysis."

Hemodialysis cleans the blood in patients who have kidney failure and are unable to remove waste through their urine.

The study, led by Bessie Young, MD, an associate professor of medicine in the Division of Nephrology at the University of Washington, Seattle, looked at the benefits and barriers to home hemodialysis.

They focused on patients, doctors, facilities where dialysis occurs and practices and reviewed the trends of home hemodialysis over the last 40 years.

The barriers with using it will go away if both physicians and patients learn how to use the system more, researchers said.

Doctors had been reluctant to start this dialysis program on patients because they have little experience with it themselves.

Currently, less than 2 percent of dialysis patients across the country use the system.

According to the authors, the benefits of home hemodialysis include:
 ⁃ Shorter, more frequent treatments during the day or done at night
 ⁃ Improved quality of life
 ⁃ More independence and employment potential
 ⁃ Greater ability to travel
 ⁃ 20-50 percent less costly than getting treated in-center, depending on the machine

And the barriers include:
 ⁃ Lack of education and awareness about home hemodialysis among patients
 ⁃ Possible fear of change and lack of self-confidence among patients
 ⁃ Doctors' education about home hemodialysis
 ⁃ Knowing how to use the machinery, though the newer ones are easier-to-use
 ⁃ Unable to pay for home hemodialysis training

With severe kidney disease and the need for treatments, according to Rajnish Mehrotra, MD, professor of medicine in the Division of Nephrology at UW Medicine and one of the co-authors of the study, there's virtually no other disease that requires patients to make as many changes in their lifestyle.

"To ease the challenge associated with such a diagnosis, offering patients choice allows them to select a dialysis therapy that best fits into their lifestyle and their expectations," he said in a press release.

The authors have served on advisory boards, done consulting work, and received grant support from companies and committees of note to their study.

The study also received support from the Veterans Affairs Puget Sound Health Care System.

The study was published online October 4 in the Clinical Journal of the American Society of Nephrology.

Review Date: 
October 5, 2012