Open AccessHome dialysis: A Dutch perspective
Author(s) -
Boeschoten Elisabeth W.,
Michels Wieneke M.
Publication year - 2011
Publication title -
dialysis & transplantation
Language(s) - English
Resource type - Journals
eISSN - 1932-6920
pISSN - 0090-2934
DOI - 10.1002/dat.20562
Subject(s) - medicine , peritoneal dialysis , dialysis , home hemodialysis , reimbursement , modalities , home dialysis , hemodialysis , intensive care medicine , transplantation , treatment modality , health care , social science , sociology , economics , economic growth
For patients with end‐stage renal disease who are not (yet) eligible for renal transplantation, treatment with dialy‐sis is mandatory for survival. Home dialysis modalities (home hemodialysis or peritoneal dialysis) offer patients more exibility compared with in‐center treatment and have been advocated as the rst choice in clinically stable patients. However, despite encouraging developments in dialysis systems that make the procedure easier, in many countries the proportion of patients using home dialysis, especially peritoneal dialysis, is decreasing. In Europe this decrease is most pronounced in the Netherlands and the United Kingdom. This evolution cannot be motivated by an inferiority of home dialysis modalities compared with in‐center treatment, as all these modalities have been shown to generate similar results. Other, often non‐medical, factors (such as reimbursement, social and logistic issues, and the experience of physicians and nurses with home dialysis) seem to be responsible for this development.