Increasing home-based dialysis therapies to tackle dialysis burden around the world: A position statement on dialysis economics from the 2nd Congress of the International Society for Hemodialysis

摘要

1. The global increase in end-stage renal failure patients poses significant stresses on health care systems around the world. 2. The current worldwide provision of the majority of renal replacement therapy via in-center hemodialysis (HD) is costly. 3. The provision of home-based therapies, as either home HD (HHD) or peritoneal dialysis (PD), is less costly than in-center HD, in most parts of the world. 4. Home therapies provide a level of empowerment to patients that impact positively on their patient outcome and quality of life. 5. Proactive predialysis patient education on the availability of dialysis modalities including in-center HD, home-based HD, and home-based PD programs (continuous ambulatory peritoneal dialysis [CAPD] and automated PD) should be enhanced in order to improve patient choice regarding their dialysis regimen. 6. The dialysis community should engage with local governments and Health Authorities to discuss the planning and provision of dialysis modalities with a view to providing the most cost-effective therapies. 7. Local governments and Health Authorities should actively plan the increase use of home dialysis modalities in order to maximize health care resources for treating end-stage renal disease (ESRD) patients. 8. Academic training of both doctors and nurses on home dialysis therapies especially for PD should be enhanced in order to promote more home dialysis.