Home Hemodialysis: Clinical Benefits, Risks, Target Populations
DOI:
https://doi.org/10.25796/bdd.v8i1.86863Keywords:
home dialysis, intensive hemodialysis, long nocturnal hemodialysis, survival, Dialysis mortality, in center hemodialysis, quotidian hemodialysisAbstract
Home hemodialysis, and in particular intensive home hemodialysis, has seen renewed development since the early 2010s, linked to low-flow dialysate techniques and the use of more manageable monitors. A number of studies have demonstrated a clinical benefit in terms of survival and cardiovascular risk reduction, pointing in particular to this technique in patients at high cardiovascular risk and with difficult access to renal transplantation. However, these benefits must be balanced against potential risks linked essentially to the increased frequency of sessions rather than being at home: increased complications of vascular approaches, loss of residual renal function, and burnout. Optimal patient selection, appropriate training, and regular follow-up will optimize the benefits relative to the potential risks.
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