Intensive Home Hemodialysis: An Eye at the past and Looking for the Hemodialysis of the Future

Abstract

The results of many observational studies and some randomized clinical trials seem to point toward intensive home hemodialysis (IHD) as being able to improve the outcome of uremic patients under chronic dialysis with a cost/benefit ratio more favorable than conventional hemodialysis. The increasing interest in home hemodialysis in the last years is due to its identification as the easiest strategic option for the realization of programs of intensive hemodialysis. However, a careful attention has to be paid in the selection of candidate patients for home hemodialysis; specifically, the psychosocial, demographic, and clinical factors are some of the aspects that need a major consideration due to their impact on the success of such programs. Further studies are strongly needed to better clarify the clinical ground and the limits of IHD use in dialysis patients.