President Trump's executive order today that will revamp kidney care and organ transplantation is expected to include proposals to encourage greater use of at-home dialysis.
Our July 2018 issue featured a story by Charlotte Huff about peritoneal dialysis, the method most commonly used in at-home dialysis. You can read the full-text version here.
Dialysis in the United States is geared so much toward dialysis centers that it is difficult to persuade clinicians that peritoneal treatment might be better for some of their patients, says Arshia Ghaffari, DO, a peritoneal dialysis researcher who directs dialysis services at the University of Southern California in Los Angeles. “You sort of hear grumblings that ‘We don’t have the staff. We don’t have the space. We don’t have the experience.’”
Huff cited that a 2017 United States Renal Data System report that found that less than 10% of American dialysis patients start dialysis on the peritoneal method. The same report said that in 2015, peritoneal dialysis was about $13,000 less expensive per year than clinic-based dialysis ($75,140 vs. $88,750). Some bundled payment changes may have evened out the cost somewhat
Standard hemodialysis can also be done at home but at-home dialysis more often uses the peritoneal method, which, as Huff described, involves pumping a solution into the peritoneum to absorb waste products out of the blood. Standard hemodialysis involves pumping the blood through a filtering machine that is outside the body.