Longer and better lives for patients ... and their centers: A strategy for building a home hemodialysis program

Physicians should prescribe the dialysis mode most likely to result in the best outcome for the end‐stage renal disease patient, not leave it to the patient or dialysis center to choose. That prescription, in order of decreasing desirability, should be for frequent home nocturnal hemodialysis, frequ...

Full description

Saved in:
Bibliographic Details
Published in:Hemodialysis international 2008-01, Vol.12 (1), p.1-5
Main Author: HODGE, Melville H.
Format: Article
Language:English
Subjects:
Activities of Daily Living
Attitude to Health
Bone Diseases - prevention & control
dialysis centers
Frequent dialysis
Heart Failure - prevention & control
Home Care Services
home dialysis
Humans
nocturnal dialysis
Patient Satisfaction
quality of life
Renal Dialysis - adverse effects
Renal Dialysis - methods
Renal Dialysis - standards
short-daily dialysis
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Physicians should prescribe the dialysis mode most likely to result in the best outcome for the end‐stage renal disease patient, not leave it to the patient or dialysis center to choose. That prescription, in order of decreasing desirability, should be for frequent home nocturnal hemodialysis, frequent home short‐daily, or least efficacious, 3x in‐center or peritoneal dialysis. Patient limitations may require prescribing a less than optimal mode. Physician‐patient discussions should focus on expected clinical outcomes and health benefits, not patient convenience or “lifestyle.” In order to overcome natural fears, qualified patients should participate in a short in‐center frequent dialysis personal clinical trial to experience the benefits. The financial health of dialysis centers will be enhanced by shifting continually inflating labor costs from the center to patients and home caregivers. This shift from 3x in‐center to frequent (optimally 6x nocturnal) home dialysis may reasonably be expected to enhance the survival and well‐being of both the patient and the center.
ISSN:1492-7535
1542-4758
DOI:10.1111/j.1542-4758.2008.00232.x