Home Hemodialysis: Six Years' Experience

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Abstract
Fifty-two patients trained for unattended overnight home hemodialysis were followed for six to 64 months. The overall mortality was 31 per cent. Deaths and morbidity were associated mainly with complications only indirectly related to uremia and in many cases related to the dialysis treatment. More than 80 per cent of the patients were rehabilitated and returned to their previous occupations. Psychologic problems were appreciable in 19 per cent of patients and moderate in 16 per cent, but 65 per cent adjusted well to home hemodialysis. Many of the difficulties that these patients experienced were related to anticoagulation, cannulas and equipment malfunctions. Home hemodialysis has medical, psychologic, financial and logistical advantages over center dialysis. Future improvements required include portable anticoagulant-free equipment, an alternative to overnight dialysis for some patients, better circulatory access, improvement in equipment reliability and service, better physician education, and development of regional dialysis and transplant programs for patients with end-stage renal disease.

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