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Home hemodialysis (HHD), is the provision of hemodialysis in the home of people with stage 5 chronic kidney disease. In the United States, home hemodialysis was the most common method of renal replacement therapy in the early 1970s before the introduction of the federal End Stage Renal Disease Program under Medicare. With routine payment for dialysis secured through Medicare incenter hemodialysis quickly became the most common form of renal replacement therapy. In the late 1970s with the advent of peritoneal dialysis, another form of home dialysis, HHD went into further decline. In 2002 HHD began a resurgence in the United States with the introduction of machines designed solely for home use. People on home hemodialysis are followed by a nephrologist who writes the dialysis prescription and they rely on the support of a dialysis unit for back-up treatments and case management. Studies show that HHD improves patients' sense of well-being; the more they know about and control their own treatment the better they are likely to do on dialysis.〔(National Kidney Foundation: A to Z Health Guide )〕 ==Home hemodialysis schedules== There are three basic schedules of HHD and these are differentiated by the length and frequency of dialysis and the time of day the dialysis is carried out. They are as follows: * Conventional HHD - done three times a week for three to five hours. It is like in-centre hemodialysis (IHD), but done at home. Some patients utilize a modified conventional "EOD" (Every Other Day) strategy in which treatments are performed an average of 3.5 times a week. It is generally accepted that the "3 day gap" that occurs once a week in conventional HHD on the normal 3x/week schedule increases risk to the patient. * Short daily home hemodialysis (SDHHD) - done five to seven times a week for two to four hours per session. * Nocturnal home hemodialysis (NHHD) - done three to seven times per week at night during sleep, for six to ten hours. Thus an NHHD schedule results in a larger dose of hemodialysis per week, as do some SDHHD. More total time dialyzing, shorter periods between treatments and the fact that fluid removal speeds can be lower (thus reducing the symptoms resulting from rapid ultrafiltration), accounts for the advantages of these schedules over conventional ones. A frequent NHHD schedule has been shown to have better clinical outcomes than a conventional schedule and evidence is mounting that clinical outcomes are improved with each increase in treatment frequency. and. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Home hemodialysis」の詳細全文を読む スポンサード リンク
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