Hemodialysis in the Home

Jp, Merrill; Schupak, Eugene; Cameron, Elizabeth; Hampers, Constantine L.

doi:10.1001/jama.1964.03070180066018

Cited by 85 publications

(19 citation statements)

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“…They called it ‘nightly nocturnal home HD’. Merrill, 10 Scribner 11 and Shaldon 12 had introduced home HD as early as the mid‐1960s. Scribner and his group developed the first monitored proportioning system specifically designed for home use three times weekly and Shaldon was the first to then use this system for overnight nocturnal HD.…”

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confidence: 99%

Nocturnal haemodialysis: An Australian cost comparison with conventional satellite haemodialysis (Review Article)

et al. 2005

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SUMMARY:Dialysis is an expensive therapy, particularly considering its recurrent, protracted nature while patient numbers are also increasing. To afford dialysis for those in need, smarter, more efficient use of limited funds is mandatory. Newer techniques and improved equipment now permit safe, highly effective haemodialysis (HD) at home, alone and while asleep. Indeed, the increase in treatment hours and frequency achieved through nocturnal HD both increase HD efficiency and reduce cardiovascular stress when comparing nocturnal HD (6 nights/week for 8 h/treatment) to conventional daytime HD (4 h/treatment, three times/week). This study compares the expenditure of two distinct HD programmes in the same renal service during the Australian financial year 2003/2004. A conventional satellite HD unit (SHDU) and a nocturnal home HD programme (NHHD 6 ) are compared, with both programmes 'notionalised' to 30 patients. The state-derived funding models under which these programmes operate are explained. All wage costs, recurrent expenditure, fixed costs and the estimated costs of building and infrastructure are included. The total NHHD 6 programme expenditure was $A33 392/patient per year ($103.82/treatment) and was $3892/patient per year less (a 10.75% saving) when compared with the SHDU expenditure of $36 284/patient per year ($232.58/treatment). This represented an annual $116 750 programme saving for a 30 patient cohort. Potential additional NHHD 6 savings in erythropoietin, hospitalization and social security dependence were also identified. Home-based therapies are clinically sound, effective and fiscally prudent and efficient. Funding models should reward home-based HD. Health services should encourage home training and support systems, sustaining patients at home wherever possible.

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confidence: 99%

Nocturnal haemodialysis: An Australian cost comparison with conventional satellite haemodialysis (Review Article)

et al. 2005

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“…The fol¬ lowing is a complete listing of the causes of death: pneumonitis, 5 pa¬ tients; peritonitis, 3; endocarditis, 2; septicemia, 2; congestive heart fail¬ ure, 11; acute myocardial infarction, 7; cerebrovascular accident, 5; peri¬ carditis, 3; arrhythmia, 3; hyperkalemia, 3; gastrointestinal bleeding, 2; scleroderma, 1; bowel infarction, 1; and adrenal insufficiency, 1 Eleven patients were initially stabilized at the satellite and then transferred to the home program.…”

Section: Methodsmentioning

confidence: 99%

Outpatient Dialysis

Neff¹

1973

Arch Intern Med

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“…In 1963–1964, two other programs were also looking at home hemodialysis as a less expensive alternative to outpatient treatment. In Boston, John Merrill and coworkers were using the twin‐coil dialyzer for this, with a nurse going to the home to supervise the treatments (10). At the same time, Stanley Shaldon and his colleagues in London began home hemodialysis using a setup similar to the Seattle system, and they were the first to use overnight home hemodialysis (11).…”

Section: The Early Years: 1961–1973mentioning

confidence: 99%

The History of Home Hemodialysis: A View From Seattle

Blagg

1997

Home Hemodialysis International

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Home hemodialysis was first used for the treatment of end-stage renal disease in the early 1960s, primarily as a means of reducing the cost of treatment. It was soon found to be an effective form of treatment that provided patient independence, greater opportunity for rehabilitation, and better survival. In 1973, when the Medicare End-Stage Renal Disease Program began, some 40% of all U.S. dialysis patients were on home hemodialysis, but since then the percentage of patients on this treatment has steadily decreased. There are several reasons for this, one in particular being the lack of availability of suitable equipment. There is now renewed interest in home hemodialysis sparked by the knowledge that new equipment specifically designed for this is being developed, that this is the modality with the best survival rate, greatest opportunity for adequate dialysis and best quality of life, and an interest in the use of daily (or nightly) home hemodialysis. Consequently, more than 30 years later, it appears that home hemodialysis may again become the preferred treatment for many more patients.

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Hemodialysis in the Home

Cited by 85 publications

References 0 publications

Nocturnal haemodialysis: An Australian cost comparison with conventional satellite haemodialysis (Review Article)

Nocturnal haemodialysis: An Australian cost comparison with conventional satellite haemodialysis (Review Article)

Outpatient Dialysis

The History of Home Hemodialysis: A View From Seattle

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