Following suit, in the past 27 months, Renal Ventures Management – a dialysis provider – has doubled its number of home-based PD patients. DiGiovanni attributes this to an uptick in communication between patients and providers.

Private insurers have also changed policies in favor of home dialysis. This year, the health insurance company Aetna modified its long-standing policy and deemed the home dialysis equipment from Nx- Stage “medically necessary” rather than “experimental.”

Challenges for home HD
In a 2009 survey, 66 percent of physicians and 49 percent of nurses said they would choose home HD over in-center care if they knew they would never receive a kidney transplant. Last December, the American Journal of Kidney Diseases reported that 75 percent of patients beginning in-center HD are unaware of the option to dialyze at home, but once informed, 40 percent of patients are interested in the option.

“Some patients who utilize home dialysis therapies today were previously treated in a dialysis center,” says Maureen Lyden Green, vice president of home therapies marketing at Fresenius Medical Care. “Many tell us that they were not aware that being treated at home was an option, and that there are machines and supplies that are specifically designed to make it easy to perform treatments at home with proper training and ongoing support.”

Besides possible health benefits, home treatment also offers patients greater flexibility and comfort. However, home HD is not for everyone, as some patients prefer having access to professional assistance in a clinic or do not have someone at home to help with treatment. The treatment is also complicated to learn, and training can take several weeks.

To help combat those challenges, companies like NxStage and Fresenius have worked to make home HD less daunting, more portable and easier to use.

“We created a new user interface that collects information from the patient and sends it to his or her doctor, instead of the patient having to write everything down,” says Jeff Burbank, CEO and founder of NxStage Medical.

One new feature Fresenius added to its home dialysis machine is the WetAlert wireless wetness detector, which is designed to detect venous needle displacement and prevent blood loss by interacting with the machine to create an audible and visual alarm, stop the blood pump and clamp the venous line.

The future of dialysis
Looking ahead, dialysis machines will become smaller and easier to operate, manufacturers predict.

December 2012 Magazine

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