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Home Dialysis a Good Option for Kidney Disease Patients

Survival rates similar to those with deceased donor transplant organs, study shows

THURSDAY, Aug. 27 (HealthDay News) -- People with kidney disease may do just as well receiving treatment at home as undergoing a kidney transplant from a deceased donor, new research has found.

Researchers in Canada performed a 12-year follow-up study of 1,239 patients who had either received a kidney transplant from a deceased donor or who received night home hemodialysis.

The study found that patients who received the home treatment had survival rates similar to those who had transplants.

In night home hemodialysis, patients' blood is cleared of toxins that would normally be removed by the kidneys during sleep. Treatments last six-to-eight hours, longer than in a conventional dialysis center, up to seven nights a week.

Survival rates for those who received a transplant from a living kidney donor was better than for both the home dialysis and deceased donor recipients, according to the study published in the September issue of Nephrology Dialysis Transplantation.

Night home hemodialysis may be a "bridge to transplant" or a "suitable alternative" to transplant if a patient is at too high of a risk for a transplant or unable to find a suitable donor due to ongoing organ shortages, the study authors noted in a news release from University Health Network.

"This study allows me to actually answer what my patients have been asking me for over a decade: 'What does night home hemodialysis mean for my life span?' I can now tell them that this specific dialysis option is as good as getting a transplant from a deceased donor," Dr. Christopher Chan, medical director of home hemodialysis at Toronto General Hospital and an associate professor at University of Toronto, stated in the news release.

In the study, the researchers took into account age, race, diabetic status and duration of treatment with conventional in-center dialysis using data from the U.S. Renal Data System.

Over the course of 12 years, 14.7 percent of night home hemodialysis patients died, compared with 14.3 percent for patients with transplants from deceased donors and 8.5 percent for patients who'd received living donor transplants, the study found.

While previous research has shown that patients who received transplants have better survival rates than those on dialysis, these findings show that the long, frequent dialysis provided by nocturnal treatments may have an advantage over conventional dialysis, Chan said.

After trying conventional dialysis, Florence Tewogbade, 27, switched to home hemodialysis in April 2008. "It has changed my life," Tewogbade said in the news release. "I can now work, go to school, look forward to a future and be self-reliant."

Canada has among the lowest organ donation rates of any developed nation, according to the study. Of the 4,195 Canadians on a waiting list for a transplant, 71 percent needed a kidney.

About 2 percent of people on the waiting list die while waiting for a donor, according to the study.

More information

The U.S. National Kidney Foundation has more on night home hemodialysis.

-- Jennifer Thomas

SOURCE: University Health Network, news release, Aug. 20, 2009

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