Haemodialysis at home: review of current dialysis machines

摘要

Introduction: Only a minority of patients with chronic kidney disease treated by hemodialysis are currently treated at home. Until relatively recently, the only type of hemodialysis machine available for these patients was a slightly smaller version of the standard machines used for in-center dialysis treatments.Areas covered: There are now an alternative generation of dialysis machines specifically designed for home hemodialysis. The home dialysis patient wants a smaller machine, which is intuitive to use, easy to trouble shoot, robust and reliable, quick to setup and put away, requiring minimal waste disposal. The machines designed for home dialysis have some similarities in terms of touch-screen patient interfaces, and using pre-prepared cartridges to speed up setting up the machine. On the other hand, they differ in terms of whether they use slower or standard dialysate flows, prepare batches of dialysis fluid, require separate water purification equipment, or whether this is integrated, or use pre-prepared sterile bags of dialysis fluid.Expert commentary: Dialysis machine complexity is one of the hurdles reducing the number of patients opting for home hemodialysis and the introduction of the newer generation of dialysis machines designed for ease of use will hopefully increase the number of patients opting for home hemodialysis.