Night home hemodialysis as good in treating kidney failure as transplant

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Washington, August 21 (ANI): A Canadian study has for the first time shown that night home hemodialysis is as good in treating kidney failure as transplants from deceased donors.

Published in Nephrology Dialysis Transplantation, the study followed a total of 1,239 patients for up to 12 years.

During that period, night home hemodialysis patients were compared to patients who received either a deceased donor kidney transplant or a living donor kidney transplant.

The study found that the survival between night home dialysis patients and those who received kidney transplants from deceased donors was comparable, while the survival of the patients who received a transplant from a living kidney donor was better than both the other groups.

Based on that finding, it may be said that night home hemodialysis, an intensive dialysis of six to eight hour sessions for up to seven times a week, may be a "bridge to transplant" or a "suitable alternative" to transplant should a patient be too high risk for a transplant or not be able to get a living or deceased donor as the organ shortage continues.

Night home hemodialysis patients were from the Toronto General and Humber River Regional Hospitals, both hospitals together representing the largest and longest established group of such patients world-wide.

"This study allows me to actually answer what my patients have been asking me for over a decade: 'What does night home hemodialysis mean for my life span?' I can now tell them that this specific dialysis option is as good as getting a transplant from a deceased donor," says Dr. Christopher Chan, Medical Director of Home Hemodialysis at Toronto General Hospital, University Health Network, the R. Fraser Elliott Chair in Home Dialysis and Associate Professor, University of Toronto.

In the study, night home hemodialysis patients' data was carefully matched with deceased and living donor kidney transplantation mortality data from the U.S. Renal Data System on characteristics like age, race, diabetic status, and duration of treatment with conventional in-centre dialysis prior to treatment.

The researcher then measured the proportion of deaths in each group, with final figures of 14.7 per cent for night home hemodialysis patients; 14.3 per cent for patients with transplants from deceased donors; and 8.5 per cent for patients with transplants from living donors.

Dr. Chan points out that the results diverge from the evidence to date that dialysis is inferior to transplantation, and that there is much benefit to be gained by long, frequent dialysis.

Florence Tewogbade, 27, who has been on home hemodialysis since April 2008, after trying conventional dialysis, said: "It has changed my life. I can now work, go to school, look forward to a future and be self-reliant."

She was on the transplant waiting list in 2004, but her living donor was found to be ineligible.

According to her, she would have had to wait about 10 years for a kidney from a deceased donor because of her specific risk factors for receiving a transplant.

"I always thought that transplant was the only option, so I didn't consider home hemodialysis. I thought I couldn't do it. But here I am, doing it, and living a normal life," she said. (ANI)

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