Authors' objectives:

To provide guidance on the use of home compared with hospital haemodialysis for patients with end-stage renal failure.

Authors' recommendations: Guidance: This document provides guidance on the location in which haemodialysis is carried out; it does not address the wider issues of frequency of dialysis sessions and how haemodialysis compares with other forms of renal replacement therapy. These recommendations are applicable only to those patients who, after detailed assessment of all their treatment options, have been defined as being suitable for haemodialysis. 1.1 It is recommended that all suitable patients should be offered the choice between home haemodialysis or haemodialysis in a hospital/satellite unit. 1.2 In general, patients suitable for home haemodialysis will be those who: - have the ability and motivation to learn to carry out the process and the commitment to maintain treatment - are stable on dialysis - are free of complications and significant concomitant disease that would render home haemodialysis unsuitable or unsafe - have good functioning vascular access - have a carer who has (or carers who have) also made an informed decision to assist with the haemodialysis unless the individual is able to manage on his or her own - have suitable space and facilities or an area that could be adapted within their home environment. 1.3 A full assessment of the patients clinical needs, social circumstances and home environment is necessary to determine his or her suitability for home haemodialysis. In order to make an informed choice about the location of haemodialysis that is most suitable for their particular circumstances, patients and all potential carers should be fully informed regarding what is involved in the different options, and the potential impact on their lives and those of their households should be discussed. All potential carer(s) should be given the opportunity to express their views independently of the patient. An opportunity to review the decision to proceed or continue with home haemodialysis should be available in the event of any change in circumstances. 1.4 Patients currently treated in hospital who are potentially suitable for home haemodialysis on clinical grounds, but who have not previously been offered a choice, should be reassessed and informed about their dialysis options. 1.5 Patients performing haemodialysis at home and their carers will require initial training and an accessible and responsive support service. The support service should offer the possibility of respite hospital/satellite unit dialysis as required.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.nice.org.uk/cat.asp?c=36747

Year Published: 2002

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: National Institute for Clinical Excellence

Contact Address: MidCity Place, 71 High Holborn, London WC1V 6NA, UK. Tel: +44 020 7067 5800; Fax: +44 020 7067 5801

Contact Name: nice@nice.nhs.uk

Contact Email: nice@nice.nhs.uk

Copyright: National Institute for Clinical Excellence (NICE)