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Home Hemodialysis

  • Giuseppe D’Amico
  • Claudio Bazzi

Abstract

Programs to teach patients to hemodialyze themselves at home were developed, mainly because of the high cost of in-center maintenance dialysis and the shortage of hospital facilities, first in Boston in 1964 (1) and subsequently in Seattle (2) and in London (3) in 1965. Both in the USA and in the UK the percentage of patients treated at home increased rapidly thereafter, with a peak of 40% of all patients on regular dialysis treatment in the USA treated by home hemodialysis (HHD) at the end of 1971 (4) and of 62% in the UK by the end of 1980 (5). Experience with this new modality of dialysis treatment extended to Australia, where more than 50% of patients were treated at home by the end of 1977 (6), to Canada where 25% of all dialysis patients underwent HHD by the end of 1977 (7) and to many countries in Europe, where around 20% were reached by the end of 1980 in Denmark, Sweden, Switzerland, Ireland, the Federal Republic of Germany and France (5). Those nephrologists and nurses who developed programs of HHD in their own centers agreed unanimously that this modality, when properly accepted by the staff and correctly presented to a selected group of potential candidates, represented the best treatment for a large percentage of uremic patients, in terms of well being, survival, independence, rehabilitation and cost. However, the expansion of HHD was not distributed equally in different countries or even in different geographical locations within single countries. In some centers, and sometimes in extended geographical areas, it was virtually ignored. Furthermore, in those countries and areas in which the acceptance had been good at the beginning, the use of HHD became progressively less regular and not so widespread through the years. In the USA the percentage of patients with end-stage renal disease (ESRD) treated by HHD, after reaching the peak of 40% in 1971, started to decrease in 1972, had already declined to 12% in 1978 (8) and was only 5.2% by end of 1984, according to data from the Health Care Financial Administration.

Keywords

Dialysis Patient Continuous Ambulatory Peritoneal Dialysis Dialysis Treatment Dialysis Session Home Treatment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Kluwer Academic Publishers 1989

Authors and Affiliations

  • Giuseppe D’Amico
  • Claudio Bazzi

There are no affiliations available

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