In-Center Hemodialysis vs. Home Dialysis: Comparison of Choice of Dialysis Modality

Résumé fourni par la source

Background: Both in-center hemodialysis (IHD) and home methods, peritoneal dialysis (PD) and home hemodialysis (HHD), have their advantages and disadvantages, but IHD continues to be the most common form of dialysis therapy even with similar mortality rates between the modalities and several studies showing a patient preference for home dialysis. Reasons for choosing a certain dialysis modality and continuing with the modality are varied and include factors of the patients, their caregivers, the healthcare monitoring system, and dialysis approach. Identifying factors a patient uses to choose a modality is important to increase the availability and utilization of the increasingly preferred and beneficial home modalities. Methods: Participants on IHD and home methods, PD and HHD, were surveyed at the Washington University in St Louis School of Medicine dialysis clinics. Survey questions included questions on deciding factors for the chosen dialysis modality and education on other modalities. Results: We enrolled 120 participants (n=90 on in-center hemodialysis and n=30 on home dialysis, 43% female, age [mean±SD] 59±14 years). Top factors for choosing in-center hemodialysis included perceived safety, convenience, or doctor choice. For home dialysis, the factors mentioned most included convenience, independence, and doctor recommendation. 69% of participants on in-center dialysis received education of other modalities, compared to 100% of participants on home dialysis. Conclusions: Our data reaffirm that modality selection is a complex process and highlight potential areas for intervention and education to increase the utilization of home dialysis.

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