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I feel strongly that one vital piece of information was omitted from the patient-education feature "Kidney Dialysis" (September 2008). Although most patients receive hemodialysis in an outpatient center, increasingly more patients receive dialysis in their home. Home hemodialysis has been available for more than 35 years, but many patients aren't aware of this option. Teach your patients about all treatment options so they can make an educated, informed choice. The recently passed Medicare Improvements for Patients and Providers Act of 2008 now mandates that patients be informed of all modalities.


With today's more user-friendly hemodialysis machines, receiving hemodialysis at home is a viable alternative for almost all patients with end-stage renal disease. With proper training, home hemodialysis is safe, cost-effective, and liberating. Many home hemodialysis patients, free from center schedules, continue to work and maintain a high quality of life.


The nonprofit Medical Education Institute has developed a Method to Assess Treatment Choices for Home Dialysis, or MATCH-D. (See for more information.)


My perspective on this issue is deeply personal. My late husband was a home hemodialysis patient for 25 years. The control and freedom provided by home hemodialysis enabled us to lead a wonderfully normal life.




Davenport, Iowa