At-home dialysis: consider the advantages.

3 November 2004 About 400,000 Americans have endstage kidney disease, in which the kidneys are working at 10% or less of their capacity. The only “cure” for the condition, which is usually caused by diabetes or hypertension, is a kidney transplant. But since donor kidneys are in short supply, most patients must resort to dialysis, a treatment that takes over many of the kidneys’ functions— especially removing wastes and excess fluids from the blood. Through dialysis, people with end-stage kidney disease not only can survive, but also often enjoy normal active lives. Most of those who need kidney dialysis choose hemodialysis, which requires getting to a dialysis center three times a week and remaining tethered to an artificial kidney machine for several hours. But there is a less-used alternative that more people should consider: peritoneal dialysis, which can be done at home. “Conventional wisdom has been that peritoneal dialysis offers people more freedom, and that people who choose this option have a greater sense of well-being,” says Neil R. Powe, M.D., a Johns Hopkins professor of medicine. Now, a study that Dr. Powe and his colleagues published in the Journal of the American Medical Association earlier this year finds that people who choose peritoneal dialysis are 50% more likely than those who choose hemodialysis to rate their overall care as excellent.