ABSTRACT
Background Observational studies showed home hemodialysis (HHD) to be associated with better survival than facility hemodialysis (HD) and peritoneal dialysis (PD). Patients on HHD have reported higher quality of life and independence. HHD is considered to be an economical way to manage end-stage kidney disease (ESKD). The coronavirus disease 2019 pandemic has had a significant impact on patients with ESKD. Patients on HHD may have an advantage over in-center HHD patients because of a lower risk of exposure to infection.Participants and Methods: We enrolled hemodialysis patients from our dialysis center. We estabilished HHD training center at first. The training center was approved by Chinese government. Doctors, nurses and engineers train and assess patients separately. There are three forms of patient monitoring: home visit, internet remote monitoring, and out-patient service. Demographic and medical data included age, gender, blood pressure, dialysis related data. Laboratory tests were conducted in our central testing laboratory including hemoglobin (Hgb), serum creatinine (Cr), urea nitrogen (BUN), uric acid (UA), albumin (Alb), calcium (Ca), phosphorus (P), parathyroid hormone (PTH), brain natriuretic peptide (BNP).Results Six patients who underwent regular dialysis in the hemodialysis center of our hospital were selected for HHD training. We enrolled 6 patients, including 4 males and 2 females. The mean age of the patients was 47.5 (34.7–55.7) years, the mean dialysis age was 33.5 (11.2–41.5) months. After an average of 16.0 (11.2–25.5) months of training, Alb, P and BNP were improved compared with baseline values. After training, three patients returned home to begin independent hemodialysis. During the follow-up, there are no serious adverse events leading to hospitalization or death, but there are several adverse events. They have been solved quickly by extra home visits of the technicians or online by remote monitoring. During the time, laboratory indicators of all the patients including Hgb, Alb, Ca, P, PTH, BNP, β2-MG remained stable before and after HHD treatment.Conclusion HHD is feasible and safe for ESRD in China, but larger-scale and longer-term studies are needed to further confirm.