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. 2025 Aug 29:gfaf171.
doi: 10.1093/ndt/gfaf171. Online ahead of print.

Trends in Home Dialysis Over the Last Decade in Europe: an ERA Registry Study

Maria Fernanda Slon-Roblero  1 , Vianda S Stel  2   3 , Emilio Sanchez-Alvarez  4 , Joaquín Manrique Escola  1 , Bruno José Fraga Dias  5 , Antonio Sarrión Auñón  6 , Pietro Manuel Ferraro  7 , Johan M De Meester  8 , Annabel Boyer  9 , Helena Rydell  10   11   12 , Kristine Hommel  13 , Anders Åsberg  14   15 , Inés Rama Arias  16 , Shona Methven  17   18 , María José Espigares Huete  19 , Alferso C Abrahams  20 , Runolfur Palsson  21   22 , Eric Goffin  23 , Nuria Aresté-Fosalba  24   25 , Aisha J Bello  26 , Viktorija Kuzema  27 , Jaakko Helve  28   29 , Julia Kerschbaum  30 , Sevcan A Bakkaloglu  31 , Maria Kislikova  32 , Kitty J Jager  2   3 , Alberto Ortiz  33   34 , Anneke Kramer  2   3
Affiliations

Trends in Home Dialysis Over the Last Decade in Europe: an ERA Registry Study

Maria Fernanda Slon-Roblero et al. Nephrol Dial Transplant. .

Abstract

Background: Home dialysis therapies could offer benefits to individuals undergoing dialysis. This study examines trends of home dialysis, including home haemodialysis (HHD) and peritoneal dialysis (PD) across European countries from 2012 to 2021, and evaluates transitions between home dialysis and other kidney replacement therapies (KRT).

Methods: Data from adult patients undergoing KRT in 13 European countries were obtained from the European Renal Association (ERA) Registry. Trends in home dialysis initiation, the number of patients receiving home dialysis by December 31st of each year, and transitions before and after home dialysis were analysed.

Results: Between 2012 and 2021, 65 246 adults initiated PD and 7 878 HHD. Over the last decade, HHD initiation rates and prevalence increased, while those for PD declined, resulting in a stable overall home dialysis initiation rate and prevalence. Home dialysis accounted for 5.8% of the total KRT prevalence. Most HHD patients transitioned from in-centre HD (ICHD, 76.6%), whereas 86.9% of PD patients had no prior KRT. Two years after initiation, 53.2% of HHD patients remained on HHD, 20.9% received a kidney transplant (KT), 16.6% transitioned to ICHD, 8.1% died while on HHD, and 0.6% switched to PD. Among PD patients, 39.6% remained on PD, 22.6% transitioned to ICHD, 18.3% received a KT, 17.4% died while on PD and 0.3% switched to HHD.

Conclusions: While the use of HHD over the past decade increased in some European countries, the use of PD has declined. The prevalence of both HHD and PD remains low, with limited transitions from other KRT options to home dialysis and between home dialysis modalities. These findings highlight the need for more effective, region-specific strategies to improve access to these modalities for patients who may benefit from it.

Keywords: home dialysis; home haemodialysis; kidney replacement therapy; peritoneal dialysis; transition.

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