True or False poll no. 67
Canadian Agency for Drugs and Technologies in Health (CADTH)
TRUE or FALSE:
Dialysis provided by a health care professional in a clinical setting offers improved health benefits compared to self-care dialysis treatment at home.
FALSE
A review of the evidence by the Canadian Agency for Drugs and Technologies in Health (CADTH) found that for eligible patients, self-care dialysis modalities at home, including home hemodialysis and peritoneal dialysis, offer clinical benefits similar to dialysis provided in hospital or in other clinical settings (e.g., community dialysis units).
When kidney transplantation is not an option, most patients with end-stage kidney disease are treated with dialysis, which is often a life-long treatment. In Canada, traditional hemodialysis that is offered in a clinical setting with the assistance of a health care professional is the most frequently used modality for these patients. However, several options for having dialysis at home, without the assistance of a health care professional, are available. These include home hemodialysis options and peritoneal dialysis (administered by the patient or a caregiver).
The review did not identify sufficient evidence or evidence from randomized controlled trials to support consistent differences in patient quality-of-life outcomes or survival between traditional hemodialysis and home hemodialysis or peritoneal dialysis. However, younger patients undergoing hemodialysis and peritoneal dialysis at home may have better survival outcomes than older patients. The review also concluded that home-based therapies are less costly than in-centre dialysis. Implementation factors, as well as patient preference, awareness and education about dialysis options, should be considered in the decision-making process for treatment.
For more information about the CADTH review on dialysis modalities, see www.cadth.ca/dialysis.