Frequent home dialysis provides survival advantage over in-center hemodialysis

PHILADELPHIA – Frequent home dialysis therapies may help prolong the lives of patients with kidney failure compared with hemodialysis treatments administered in medical centers, according to a study presented at ASN Kidney Week 2014.

Researchers led by Austin Stack, MD, MBBCh, FASN from the Graduate Entry Medical School, University of Limerick, in Ireland, analyzed national data to compare dialysis survival among 585,911 patients who started dialysis in the United States between 2005 and 2010.

Peritoneal dialysis and frequent home hemodialysis done at least six times a week offered the greatest patient survival compared to in-center hemodialysis, while home hemodialysis done only times three per week had the lowest survival rate, the authors concluded.

Among the major findings:

Patients who were treated with peritoneal dialysis were about 10% less likely to die during the study period than patients treated with standard 3-times per week in-center hemodialysis.
Patients receiving high frequency home hemodialysis delivered six times per week were 26% less likely to die during the study period than those receiving standard in-center hemodialysis.
Patients receiving less frequent home hemodialysis (four or five times per week) had mortality risks that were similar to those of patients receiving in-center hemodialysis.
Patients receiving home hemodialysis at a frequency of three times per week were 47% more likely to die than patients receiving in-center hemodialysis.

"We suggest that a treatment approach that adopts a peritoneal dialysis first or frequent home hemodialysis first strategy should be considered for all suitable patients who develop end stage kidney disease," said Dr. Stack. "Such an approach may offer superior survival, better quality of life, and be cost effective for national health care systems." -by Rebecca Zumoff

Study: "Survival Differences between Home Dialysis Therapies and In-center Haemodialysis: A National Cohort Study" (Abstract SA-PO957)

All the Kidney Week abstracts are available at https://www.asn-online.org/education/kidneyweek/archives.