Home hemodialysis: a comparison of in-center and home hemodialysis therapy in a cohort of successful home hemodialysis patients

Abstract

We retrospectively evaluated 29 patients dialyzed for 6 months in-center on Fresenius 2008H or 2008K dialysis machines followed by 6 months at home using the Fresenius 2008K@home to determine the safety and efficacy of home hemodialysis (HHD) using the 2008K@home. Patients who initiated HHD were identified from order records and qualified for inclusion if they had available records and a minimum of three pre- and postdialysis blood urea nitrogen measurements during each period. Dialysis adequacy (mean standard weekly Kt/V) remained stable during the in-center (IC; 2.3 +/- 0.7 start, 2.3 +/- 0.7 end) and home periods (2.4 +/- 0.6 start, 2.5 +/- 0.7 end). During the home period, the percentage of delivered/prescribed single pool Kt/V was 96% +/- 12%; delivered/prescribed treatment time 98% +/- 10%; delivered/prescribed blood flow 95% +/- 7%, and delivered/prescribed dialysate flow was 99% +/- 8%. Twelve patients had 69 adverse events (5.84/100 treatments) IC and 18 patients had 40 (3.34/100 treatments) at home. No deaths were reported. In conclusion, a group of successful HHD patients received their prescribed hemodialysis therapy with the same or better adequacy as provided IC with no increase in adverse events. This demonstrates that selected patients can deliver HHD as safely and effectively as when receiving hemodialysis IC.