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Home Dialysis: A cost-effective option to reduce hospital dependency

Post by on Tuesday, July 13, 2021

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Home Haemodialysis remains a relatively new therapy that places a high clinical risk activity in the community directly under the care of parents or other caregivers and patients.
Home Haemodialysis has been available as a modality since the 1960s. But the interest in home haemodialysis has been increasing over the past years because of its flexibility and huge benefits and because of concerns over community spread of COVID-19, it has greatly accelerated patient interest in home haemodialysis treatments.
1. WHAT IS HHD?
 It’s a handy tool in times of stress, Covid and busy schedules. It is a futuristic method which allows patients to choose a dialysis schedule, helping them feel more in control of both their treatment and their time. However assistance of a trained caregiver or qualified nurse is a requirement in such settings.
2. SAVES TIME AND MONEY
 Many surveys point out to the fact that 61% of patients on HHD confirmed saving time . Citing they had more time to spend with friends and family, when compared to in-centre hospital based haemodialysis.
3. SLOW AND STEADY
 Home therapies allow for longer and slower dialysis. It improves kidney function and life expectancy overall. It showed a 13% lower risk of death in patients, and a 77% improvement in their quality of life and general health.
4. NOCTURNAL DIALYSIS OPTION
 At home, there are more frequent possibilities of holding nocturnal sessions of dialysis at one's convenience which allows the patient to take control of his treatment with confidence. And keep his day for his routine official and recreational schedules.
5. FUTURISTIC STEP
With a key focus on self-responsibility and giving control back to patients. It is important to shift away from hospitals and into primary and community care, giving patients more choice on when and where they have treatment and ramping up support for people to manage their own health.
6.  NICE SUPPORT
National Institute for Clinical Excellence (NICE) 2002 advocated home dialysis as a more cost-effective treatment than hospital dialysis and recommended its expansion.
7. SELF CANNULATION
Self-cannulation is a term that refers to the patient inserting his or her own dialysis needles. Patients on HHD are trained to insert their own needles or to have their care partners insert the needles. New techniques, such as the buttonhole technique, have made self-cannulation much easier and more comfortable. Patients who self-cannulate generally have a better chance of keeping their vascular access healthy and functioning for a long period of time. 
8. MENTAL COMFORT
HHD is easier to fit in treatment around one's routine life, which can have huge benefits for your mental health, keep stress away and reduce the exposure to hospital acquired bugs. The advent of simple-to-operate home systems and a growing body of literature suggesting that patients undergoing home haemodialysis have similar or better outcomes than patients treated with conventional in-center haemodialysis has ensured reliability of this method.
9. HAPPY AT HOME
 Few surveys conducted in the last few years have indicated that 58% of patients reported increased happiness compared to in-centre dialysis.
10. REDUCES MEDICINE LIST
 Home dialysis comes with a number of clinical benefits. It reduces reliance on additional medicine,  approx  26% of HHD patients rely less on medication overall when compared to in-centre haemodialysis.
11. CARRY ALONG UNITS
 Portable machines which are purpose built for the home, such as NxStage System One, offer freedom to travel. This alleviates concerns over needing to make alternative arrangements with dialysis centres away from your hometown.
12. BE AWARE
One of the family members, will need to commit to receive training and follow the guidelines for operating the equipment.
 13. VIRTUAL LINKING
 Connectivity is another important development. Dialysis machines traditionally have been very analog, but today’s systems can instantly, securely transmit data to the cloud for providers to access remotely. This makes kidney disease treatment more convenient for patients and providers. In the home setting, utilizing smart sensors and wireless data transfer frees patients from manual data entry and ensures that providers get the information they need.
14.  NXSTAGE GADGETS
 Technological advancements will be necessary for the success of home dialysis. Today Fresenius’ The NxStage home haemodialysis machine is the first and only portable HD system cleared for home use and the only machine small enough to take on the road or even on a plane.
15. HOME DIALYSIS IN INDIA
  In Mumbai , Monthly haemodialysis sessions done by Apex Kidney Foundation, one of the few companies that offer home haemodialysis, has doubled in these Covid-19 months .
16. REVIEWS ARE  EXCELLENT
 When asked , most patients respond by saying that HHD has given them greater control and ownership of self-care, Increased independence and more flexibility in treatment scheduling, Lessened feeling of reliance and/or burden on friends and family and helped them to avoid feelings of helplessness commonly experienced by patients opting for hospital based dialysis support.
Though, Home Haemodialysis is performed only by about 1% of patients receiving chronic hemodialysis, even in the United States but considering its benefits ,patients are more likely to choose home haemodialysis when appropriate education is imparted , professional staff is offered for help, and the assurance of expertise at door and 24×7  support is ensured. 
 
Dr Nasir Shamas
Consultant Physician
JLNM Hospital

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