Leading global kidney disease organizations are addressing strategies to increase access to and uptake of home dialysis, both peritoneal dialysis and home dialysis. To boost the access, they formed an International Home Dialysis Roundtable (IHDR). IHDR met during a two-part virtual meeting (October and November 2020) to consider practical steps for increasing access to home dialysis, both during the still raging pandemic and beyond.

Members committed to collaborate to promote uptake of home dialysis on a broad scale., which included increasing the reach and influence of key stakeholders with policy makers, building a cooperative of advocates and champions for home dialysis, working together to increase the patient engagement and empowerment. Not to forget that, during COVID-19 pandemic, this challenge has become urgent as kidney disease patients, who are more susceptible to viral infections and severe complications, must be able to safely physically distance at home.

Patients dependent on dialysis can either be treated in a clinic with in-center hemodialysis, or at home through home hemodialysis (HHD) or peritoneal dialysis (PD). The COVID-19 pandemic has further emphasized the importance of enabling greater numbers of patients to perform dialysis at home, given that dialysis patients are at high risk for developing severe COVID-19 outcomes compared to the general population and treatment in a dialysis center challenges efforts to physically distance.23 Home therapies are recognized as ideal when pandemics break out, particularly compared to in-center dialysis in which patients must visit a healthcare facility at least three times per week.

It is widely accepted that a lack of adequate patient and caregiver education is one of many factors that have led to the low rates of home dialysis uptake globally, with the majority of patients receiving in-center dialysis. There is also a lack of physician knowledge related to home dialysis, with very few medical professionals having ever seen a patient performing HD or PD at home.

IHDR members agreed to document, amplify and replicate established efforts shown to improve access to home dialysis and support new policies that facilitate access through procedures, innovation and reimbursement. This is meant to expand work across countries and regions to address limitations to home dialysis and to collaborate to ensure that successful projects cand be replicated from one region to another.

Discussants made it clear they are eager to act on the commitments they made in the consensus statement and strengthen their relationships globally in order to promote home dialysis.

We invite you to read this paper on “Expanding Utilization of Home Dialysis: An Action Agenda From the First International Home Dialysis Roundtable” here:

https://www.kidneymedicinejournal.org/article/S2590-0595(21)00100-X/fulltext#secsectitle0010