History of home haemodialysis in Australia (Review Article)

Abstract

Australia has had an active and slowly expanding home haemodialysis programme; however, this has failed to expand as rapidly as some other methods of treatment of end-stage kidney disease. The technique in Australia has always been a derivative from overseas experience, rather than innovative. It received some minor initial support from the report issued in 1968 by an ad-hoc Committee of the National Health and Medical Research Council on Rationalization of Facilities for Organ Transplantation and Renal Dialysis, but was ultimately disadvantaged because the report promoted transplantation over dialysis to an extent that proved markedly disproportionate to the number of patients who, in succeeding decades, would need maintenance dialysis treatment rather than transplantation. Nevertheless, each state in Australia established home haemodialysis facilities, but major interstate variations occurred in the uptake of the modality. The subsequent development of continuous ambulatory peritoneal dialysis and limited care dialysis centres appeared to have an important negative impact on home haemodialysis, although the recent introduction of daily dialysis is likely to have a positive influence in the future.

Australian consumer perspectives on dialysis: First national census

“…9 Despite the cost, and the clinical and social benefits of home dialysis, the percentage of home dialysis patients in Australia has fallen from about half of all patients in the 1970s (even before maintenance PD was available), to less than one-third now. 10 The declining rate of home dialysis is variable within Australian. Of the New South Wales (NSW) dialysis population, 39% use home dialysis, compared with 21% in Victoria (Vic) and Western Australia (WA) and 18% in South Australia (SA).…”

Mathematical Analysis of the Long-Term Efficacy of Daily Home Hemodialysis Therapy with a Cold Dialysate Regeneration System

“…Home HD improves the quality of life of renal-failure patients, and many HD systems and methods have been developed for home HD treatment [21][22][23][24][25] . Among them, the NxStage One system [21] is a well-known, simple, portable HD system.…”

Clinical, patient-related, and economic outcomes of home-based high-dose hemodialysis versus conventional in-center hemodialysis

“…Home-based HD, with its origins in the 1960s, rapidly waned in practice in the 1980s and 1990s but is undergoing a significant revival over the last 10 years. 16 The combination of patient empowerment provided by the flexible nature of home-based HD regimes and the emergence of growing data supporting the association of such regimes with improved outcomes, such as survival, patient-reported QoL, and cost-effectiveness, are the primary drivers for this resurgence. [17][18][19] Some of the improved outcomes associated with home HD can be linked with more intensive dialysis regimes and its prescription (high-dose HD) enabled by the flexibility of schedule in the home environment.…”