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Study Finds Home Dialysis as Good as Hemodialysis at Centers
Date:9/29/2010

By Amanda Gardner
HealthDay Reporter

TUESDAY, Sept. 28 (HealthDay News) -- Patients with end-stage kidney disease who have dialysis at home fare just as well as their counterparts who do hemodialysis, which is traditionally performed in a hospital or dialysis center, new research shows.

"This is the first demonstration with a follow-up for up to five years," said Dr. Rajnish Mehrotra, lead author of the study that is published online Sept. 27 in the Archives of Internal Medicine. "Not only was there no difference, the improvements in survival have been greater for patients who do dialysis at home."

Yet patients seem loathe to pick the at-home option, known as peritoneal dialysis, even if they're aware of its existence, finds another study in the same issue of the journal.

And, as an accompanying editorial points out, the proportion of Americans using peritoneal dialysis plummeted from 14.4 percent in 1995 to about 7 percent in 2007.

Both forms of dialysis essentially act as replacement kidneys, filtering and cleaning the blood of toxins, explained Dr. Martin Zand, medical director of the kidney and pancreas transplant programs at the University of Rochester Medical Center in Rochester, N.Y.

For peritoneal dialysis, fluid is passed into the abdomen via a catheter. The body's own blood vessels then act as the filter. But patients have to be able to lift 2 liters of fluid at a time and hook it up to a pole, and to do this several times a day, Zand explained.

But hemodialysis (which can be done at home, though it takes up huge volumes of water) is generally necessary only a few times a week.

The first study analyzed national data on 620,020 patients who began hemodialysis and 64,406 patients who began peritoneal dialysis in three time periods: 1996-1998, 1999-2001 and 2002-2004.

Although patients receiving peritoneal dialysis in the earlier periods had a slightly higher risk o
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