The UK Situation

Better survival outcomes due to increased dialysis capable through home haemodialysis

A NIH study looking at 32,065 patients over a 3 year period showed a statistically significant increase in the cardiac death rate after the standard fixed 2 day break from hospital based dialysis over a weekend compared to alternate day dialysis (10.2 Vx 7.5 deaths/100 person years, p<0.001). [Foley RN, NEJM (2011):365]

A US RCT comparing frequent daily dialysis versus standard hospital based 3x/week dialysis found that the Hazard Ratio for Death was 0.7. [Chertow GM, NEJM (2010):363]

Slow & frequent nocturnal dialysis provides equal survival to a deceased donor transplant. [Pauly RP, NDT (2009)]

Better quality of life outcomes with home dialysis

A Canadian RCT over 2 years comparing frequent nocturnal dialysis of 6 days a week against standard hospital based dialysis of 3 days per week showed significant improvements in KDQOL-SF parameters of perceived burden of kidney disease and effect of kidney disease. [Cullerton BF, JAMA (2007):298]

A Japanese study looking at the outcomes of the SF-36 health survey completed by patients dialysing at home and by patients dialysing in centre reported scores that demonstrated better physical functioning, more energy, less emotional problems, less body pain, less role limitations and better social functioning in those dialysing at home. [Watanabe Y, Hemodialysis Int (2014), 18 (S1)]