Abstract

Home extracorporeal hemodialysis (HD), which had aroused great interest in the past, did not keep the promises expected due to the complexity and family commitment in managing the treatment. The portable NxStage One system was proposed from the United States, also marketed in Italy and designed for home use. 9 patients on chronic hemodialysis, 5 males and 4 females, after a period of about 15 days of training, with a partner deemed suitable, were initiated for home HD treatment with the NxStage System : 5/6 weekly dialysis sessions lasting about 150/180 minutes. In all patients, weekly clearance was evaluated according to the Leypoldt formula for Standard Kt/V, in addition to bimonthly control of the main tests. Blood control (Hospital HD vs Home HD),performed 6 months after starting home HD then compared to the same last values checked during the period in hospital HD, showed no difference in the amount of cleansing as shown by weekly KT / V, while a significant reduction was shown as regards serum urea, creatinine, uric acid, phosphorus and calcium ( not significant increase ) with reduction of the dosages of phosphorus binders (Sevelamer and Calcium Carbonate) and a significant increase of serum bicarbonate and hemoglobin even with reduction of doses of erythropoietin (darboepoietin). We conclude that the dialysis efficiency of home HD is comparable to hospital treatment, with a reduction in metabolic parameters and an increase in hemoglobin values. This method undoubtedly improves the patient's psycho-physical well-being, increases their autonomy and self-image.