Approximately 37 million people are currently living with chronic kidney disease (CKD) in the U.S., and experts anticipate that number will rise significantly over the next decade. Of the 661,00 Americans with kidney failure, more than two-thirds (⅔) are already on dialysis.

The overwhelmed U.S. healthcare system is seeking additional effective—and cost-effective—ways to care for patients with end-stage renal disease (ESRD). One underutilized option that’s receiving new attention is home dialysis.* 

Home dialysis vs. in-center dialysis

Both hemodialysis and peritoneal dialysis (PD) can be performed at home, and new technologies are streamlining this process—making it more simple than ever before.

The benefits of home dialysis vs. in-center dialysis fall into three categories:

• clinical;
• emotional/psychological; and
• financial.

Clinical

Among other outcomes, patients using home hemodialysis have been found to enjoy significant improvements regarding: 

• blood pressure, anemia, and phosphorus control with fewer medications; 
• sleep quality and energy levels;
• physical symptoms during, and recovery time from, dialysis treatments; and 
• number and length of hospital stays.

Emotional/Psychological

Patients have also reported emotional and psychological advantages to at-home dialysis including:

• a familiar, more comfortable setting;
• greater control over schedule and treatments;
• the stability of a consistent treatment partner; and
• overall health-related quality of life.

Financial

In-center dialysis costs approximately $67,733 per Medicare beneficiary per plan year. Patients with ESRD make up <1% of beneficiaries, but cost Medicare more than $35 billion annually—about 7.2% of its fee-for-service spending. 

In contrast to in-center hemodialysis, home-based peritoneal dialysis costs around $48,796 per beneficiary per plan year. A 5% increase in peritoneal home dialysis alone could save nearly  $300 million annually, and those savings can trickle down to end-users.

How will this change for ESRD patients moving forward?

Given the many advantages to both patients and payers, the Centers for Medicare and Medicaid Services (CMS) have set the goal of getting 50% of ESRD patients on home dialysis. Several private kidney care centers have taken up this objective, as well. 

Despite the benefits, all options have some drawbacks. It’s important to discuss all available options, including their pros and cons, with your healthcare provider. The decision about what’s best for you is ultimately yours to make. 

*Hohmann, S. (2019, Dec. 2). “Home Dialysis Options Can Assist in Clinical Decision-Making.” Nephrology News & Issues.