Home dialysis, though cheaper, can prolong life

NEW YORK — Fewer than 10 percent of kidney patients undergo dialysis at home even though the treatment costs less and may be more effective at prolonging life, a new investigation has found.

An estimated 382,000 people are receiving kidney dialysis nationwide, but only 35,000 are on one of the two forms of home-based dialysis, say doctors in a special American Journal of Kidney Diseases report.

Most patients choose to undergo dialysis in a center, either a freestanding facility or one connected with a medical center.

Home dialysis methods have existed for decades, doctors said, but have not been widely pursued or publicized. One is known as home hemodialysis; the other, peritoneal dialysis.

Home hemodialysis is performed almost identically to dialysis in a center. Peritoneal dialysis uses a solution that is self-infused into the abdomen that flushes out excess fluid and toxins. Both can be performed daily.

The report revealed three-quarters of newly diagnosed patients were unaware of those options.

"Home hemodialysis isn't new, it has been around since the 1970s, but it fell off the radar after dialysis centers wound up on just about every other corner," said Dr. Beth Piraino, one of the study's senior authors and president-elect of the National Kidney Foundation.

Undergoing dialysis in a center costs about $70,000 a year, Piraino said Friday, but undergoing the procedure at home can shave $20,000 or more off annual costs, she said.

Federal and private insurers, Piraino added, cover costs associated with home care.

In Hong Kong, Piraino said, all patients undergo home hemodialysis. Not only is life expectancy longer, she said, patients have fewer complications than their U.S. counterparts.