In the United States, 93% of the patients are treated with in-center hemodialysis (HD), about 7% undergo peritoneal dialysis (PD) at home and less than 1% are on home hemodialysis (HD). A survey revealed that more than 90% of the Nephrology professionals would chose home HD for their primary treatment option if they were a dialysis patient.
Typically PD is considered to be the best initial therapy by Nephrology professionals. However, when asked what they would choose as initial dialysis treatment while awaiting a transplant, 50% of Nephrologists chose home HD, either short daily or nocturnal, and only 43% chose PD. Similar results were found for nurses with 45% choosing home HD and only 44% choosing PD. Considering that most Nephrology professionals would prefer home HD and PD themselves, it raises the question as to why more patients do not choose home dialysis generally. This is despite the fact that many physicians believe that between 25-35 percent of patients would do better if they were on a home dialysis therapy.
Among reasons cited by Nephrology professionals polled for choosing home dialysis were more treatment flexibility, control over their own therapy, and most importantly, better results. The main reason for choosing in-center HD modality was that the polled professionals wanted to be taken care of by a trained healthcare team.
Much discussion and controversy exists around the question of the best dialysis therapy for those with End Stage Renal Disease (ESRD). Non-medical factors that impact a person's ultimate treatment option include:
- Economic limitations
- Lack of medical evidence for superior outcomes
- Enhanced risk associated with therapies
- Knowledge of individual treatments
- Variable access to different therapies
Though a majority of health professionals within the Nephrology community would prefer home HD over in-center dialysis, KidneyBuzz.com recommends that you work with your healthcare team to determine the best mode of treatment for you at this time.
U.S. National Library of Medicine, Perceptions about renal replacement therapy among nephrology professionals (Abstract).
Nephrology News & Issues, Perceptions about renal replacement therapy among nephrology professionals.