Haemodialysis is the most common treatment for end-stage renal failure. Blood is shunted through an extracorporeal circulation in which waste products and excess fluid are removed by the physical processes of diffusion and ultrafiltration.
- home haemodialysis (HD) has the best patient outcomes (1,2) and is the most
cost-effective of any dialysis modality, but its use has been declining in
- prevalence of home HD varies from 0 to 58.4 per million population, and varies between countries, more than any other renal replacement therapy (RRT) modality
- variation cannot be explained by the variation in the use of other RRT
modalities, nor by prevalence of diabetic nephropathy, national wealth
or population density
according to the 19th annual report by the UK Renal Registry (2016), on 31 December 2015 there were 61,256 adults in the UK receiving RRT
- of these, 53.1% had received a transplant, 41.0% were receiving haemodialysis (21.2% in satellite units, 17.8% in hospitals, 2.0% at home), 2.5% were receiving continuous ambulatory peritoneal dialysis and 3.4% were receiving automated peritoneal dialysis
- in addition, 769 children and young people under the age of 16 years
were receiving RRT
- most had received a transplant (41% live, 34% deceased), with 13% on haemodialysis and 12% on peritoneal dialysis
- median age of all people newly requiring RRT was 59.0 years; 22.7% of people were from minority ethnic groups
- MacGregor MS et al. Home haemodialysis-international trends and variation. Nephrol Dial Transplant. 2006 Jul;21(7):1934-45.
- Mowatt G et al. Systematic review of the effectiveness of home versus hospital or satellite unit hemodialysis for people with end-stage renal failure. Int J Technol Assess Health Care. 2004 Summer;20(3):258-68
- NICE (October 2018). Renal replacement therapy and conservative management