Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

Intensive home haemodialysis: benefits and barriers

Nature Reviews Nephrology volume 8, pages 515–522 (2012)Cite this article

Subjects

Abstract

Accumulating evidence of the benefits of intensive home haemodialysis has led to increased international interest in this modality as a viable option for renal replacement therapy. Until the late 1970s, haemodialysis was primarily performed at home; however, the development of in-centre and satellite dialysis units and the advent of peritoneal dialysis led to decreased numbers of patients being managed by home haemodialysis. Over the past decade, a move towards once again providing and supporting haemodialysis at home has emerged, due to a desire to offer a more convenient form of dialysis for the patient in a more cost-effective manner. This shift has generated clinical evidence indicating benefits both from receiving haemodialysis at home, and from the option to provide intensive dialysis treatment in this setting. With the development of new home haemodialysis programs, specific patient-related, physician-related and cost-related barriers to their introduction have been encountered, including patient fear of self-cannulation and lack of expert medical knowledge in the area. This Review discusses the benefits and barriers associated with intensive home haemodialysis.

Key Points

  • Intensive home haemodialysis (IHHD) is associated with established clinical benefits, including reductions in blood pressure and serum phosphate, and amelioration of left ventricular hypertrophy

  • IHHD might potentially improve patient outcomes, such as survival and quality of life

  • Important barriers to the widespread use of IHHD include accessibility problems, a lack of physician experience and a lack of patient awareness

  • Future research in the area of IHHD should concentrate on overcoming the obstacles to its use

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Barriers to the use of IHHD.

Similar content being viewed by others

References

  1. George, C. R. History of home haemodialysis in Australia. Nephrology (Carlton) 10, 215–221 (2005).

    Article  Google Scholar 

  2. Woods, J. D., Port, F. K., Stannard, D., Blagg, C. R. & Held, P. J. Comparison of mortality with home hemodialysis and center hemodialysis: a national study. Kidney Int. 49, 1464–1470 (1996).

    Article  CAS  PubMed  Google Scholar 

  3. Nitsch, D. et al. Outcomes in patients on home haemodialysis in England and Wales, 1997–2005: a comparative cohort analysis. Nephrol. Dial. Transplant. 26, 1670–1677 (2011).

    Article  PubMed  Google Scholar 

  4. Bremer, B. A., McCauley, C. R., Wrona, R. M. & Johnson, J. P. Quality of life in end-stage renal disease: a reexamination. Am. J. Kidney Dis. 13, 200–209 (1989).

    Article  CAS  PubMed  Google Scholar 

  5. Evans, R. W. et al. The quality of life of patients with end-stage renal disease. N. Engl. J. Med. 312, 553–559 (1985).

    Article  CAS  PubMed  Google Scholar 

  6. Lee, H. et al. Cost analysis of ongoing care of patients with end-stage renal disease: the impact of dialysis modality and dialysis access. Am. J. Kidney Dis. 40, 611–622 (2002).

    Article  PubMed  Google Scholar 

  7. MacGregor, M. S., Agar, J. W. & Blagg, C. R. Home haemodialysis—international trends and variation. Nephrol. Dial. Transplant. 21, 1934–1945 (2006).

    Article  PubMed  Google Scholar 

  8. Agar, J. W., Hawley, C. M. & Kerr, P. G. Home hemodialysis in Australia and New Zealand: how and why it has been successful. Semin. Dial. 24, 658–663 (2011).

    Article  PubMed  Google Scholar 

  9. Collins, A. J. et al. United States Renal Data System 2011 Annual Data Report: atlas of chronic kidney disease & end-stage renal disease in the United States. Am. J. Kidney Dis. 59 (Suppl. 1), e1–420 (2012).

    Google Scholar 

  10. Lacson, E. Jr et al. Survival with three-times weekly in-center nocturnal versus conventional hemodialysis. J. Am. Soc. Nephrol. 23, 687–695 (2012).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Charra, B. et al. Long thrice weekly hemodialysis: the Tassin experience. Int. J. Artif. Organs 27, 265–283 (2004).

    Article  CAS  PubMed  Google Scholar 

  12. Chertow, G. M. et al. In-center hemodialysis six times per week versus three times per week. N. Engl. J. Med. 363, 2287–2300 (2010).

    Article  CAS  PubMed  Google Scholar 

  13. Pauly, R. P. et al. Patient and technique survival among a Canadian multicenter nocturnal home hemodialysis cohort. Clin. J. Am. Soc. Nephrol. 5, 1815–1820 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kjellstrand, C. et al. Survival with short-daily hemodialysis: association of time, site, and dose of dialysis. Hemodial. Int. 14, 464–470 (2010).

    Article  PubMed  Google Scholar 

  15. Marshall, M. R. et al. Home hemodialysis and mortality risk in Australian and New Zealand populations. Am. J. Kidney Dis. 58, 782–793 (2011).

    Article  PubMed  Google Scholar 

  16. Johansen, K. L. et al. Survival and hospitalization among patients using nocturnal and short daily compared to conventional hemodialysis: a USRDS study. Kidney Int. 76, 984–990 (2009).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Lockridge, R. S. & Kjellstrand, C. M. Nightly home hemodialysis: outcome and factors associated with survival. Hemodial. Int. 15, 211–218 (2011).

    Article  PubMed  Google Scholar 

  18. Nesrallah, G. E. et al. Intensive hemodialysis associates with improved survival compared with conventional hemodialysis. J. Am. Soc. Nephrol. 23, 696–705 (2012).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Weinhandl, E. D., Liu, J., Gilbertson, D. T., Arneson, T. J. & Collins, A. J. Survival in daily home hemodialysis and matched thrice-weekly in-center hemodialysis patients. J. Am. Soc. Nephrol. 23, 895–904 (2012).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Kjellstrand, C. M. et al. Short daily haemodialysis: survival in 415 patients treated for patient-years. Nephrol. Dial. Transplant. 23, 3283–3289 (2008).

    Article  PubMed  Google Scholar 

  21. Pauly, R. P. et al. Survival among nocturnal home haemodialysis patients compared to kidney transplant recipients. Nephrol. Dial. Transplant. 24, 2915–2919 (2009).

    Article  PubMed  Google Scholar 

  22. Kooistra, M. P., Vos, J., Koomans, H. A. & Vos, P. F. Daily home haemodialysis in The Netherlands: effects on metabolic control, haemodynamics, and quality of life. Nephrol. Dial. Transplant. 13, 2853–2860 (1998).

    Article  CAS  PubMed  Google Scholar 

  23. McFarlane, P. A., Pierratos, A., Bayoumi, A. M. & Redelmeier, D. A. Estimating preference scores in conventional and home nocturnal hemodialysis patients. Clin. J. Am. Soc. Nephrol. 2, 477–483 (2007).

    Article  PubMed  Google Scholar 

  24. Heidenheim, A. P., Muirhead, N., Moist, L. & Lindsay, R. M. Patient quality of life on quotidian hemodialysis. Am. J. Kidney Dis. 42, 36–41 (2003).

    Article  PubMed  Google Scholar 

  25. Vos, P. F. et al. Effect of short daily home haemodialysis on quality of life, cognitive functioning and the electroencephalogram. Nephrol. Dial. Transplant. 21, 2529–2535 (2006).

    Article  PubMed  Google Scholar 

  26. Van Eps, C. L. et al. Quality of life and alternate nightly nocturnal home hemodialysis. Hemodial. Int. 14, 29–38 (2010).

    Article  PubMed  Google Scholar 

  27. Mohr, P. E. et al. The case for daily dialysis: its impact on costs and quality of life. Am. J. Kidney Dis. 37, 777–789 (2001).

    Article  CAS  PubMed  Google Scholar 

  28. Culleton, B. F. et al. Effect of frequent nocturnal hemodialysis vs conventional hemodialysis on left ventricular mass and quality of life: a randomized controlled trial. JAMA 298, 1291–1299 (2007).

    Article  CAS  PubMed  Google Scholar 

  29. Rocco, M. V. et al. The effects of frequent nocturnal home hemodialysis: the Frequent Hemodialysis Network Nocturnal Trial. Kidney Int. 80, 1080–1091 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  30. Mowatt, G., Vale, L. & MacLeod, A. Systematic review of the effectiveness of home versus hospital or satellite unit hemodialysis for people with end-stage renal failure. Int. J. Technol. Assess Health Care 20, 258–268 (2004).

    Article  PubMed  Google Scholar 

  31. Jaber, B. L. et al. Effect of daily hemodialysis on depressive symptoms and postdialysis recovery time: interim report from the FREEDOM (Following Rehabilitation, Economics and Everyday-Dialysis Outcome Measurements) Study. Am. J. Kidney Dis. 56, 531–539 (2010).

    Article  PubMed  Google Scholar 

  32. Woods, J. D. et al. Clinical and biochemical correlates of starting “daily” hemodialysis. Kidney Int. 55, 2467–2476 (1999).

    Article  CAS  PubMed  Google Scholar 

  33. Kraus, M. et al. A comparison of center-based vs. home-based daily hemodialysis for patients with end-stage renal disease. Hemodial. Int. 11, 468–477 (2007).

    Article  PubMed  Google Scholar 

  34. Chan, C. T., Floras, J. S., Miller, J. A., Richardson, R. M. & Pierratos, A. Regression of left ventricular hypertrophy after conversion to nocturnal hemodialysis. Kidney Int. 61, 2235–2239 (2002).

    Article  PubMed  Google Scholar 

  35. Lockridge, R. S. Jr et al. Nightly home hemodialysis: five and one-half years of experience in Lynchburg, Virginia. Hemodial. Int. 8, 61–69 (2004).

    Article  PubMed  Google Scholar 

  36. McGregor, D. O., Buttimore, A. L., Lynn, K. L., Nicholls, M. G. & Jardine, D. L. A comparative study of blood pressure control with short in-center versus long home hemodialysis. Blood Purif. 19, 293–300 (2001).

    Article  CAS  PubMed  Google Scholar 

  37. Nesrallah, G., Suri, R., Moist, L., Kortas, C. & Lindsay, R. M. Volume control and blood pressure management in patients undergoing quotidian hemodialysis. Am. J. Kidney Dis. 42, 13–17 (2003).

    Article  PubMed  Google Scholar 

  38. Chan, C. T. et al. Short-term blood pressure, noradrenergic, and vascular effects of nocturnal home hemodialysis. Hypertension 42, 925–931 (2003).

    Article  CAS  PubMed  Google Scholar 

  39. Paoletti, E. et al. The worsening of left ventricular hypertrophy is the strongest predictor of sudden cardiac death in haemodialysis patients: a 10 year survey. Nephrol. Dial. Transplant. 19, 1829–1834 (2004).

    Article  PubMed  Google Scholar 

  40. Susantitaphong, P., Koulouridis, I., Balk, E. M., Madias, N. E. & Jaber, B. L. Effect of frequent or extended hemodialysis on cardiovascular parameters: a meta-analysis. Am. J. Kidney Dis. 59, 689–699 (2012).

    Article  PubMed  PubMed Central  Google Scholar 

  41. Traeger, J., Galland, R., Delawari, E., Arkouche, W. & Hadden, R. Six years' experience with short daily hemodialysis: do the early improvements persist in the mid and long term? Hemodial. Int. 8, 151–158 (2004).

    Article  PubMed  Google Scholar 

  42. Chan, C. T. et al. Determinants of left ventricular mass in patients on hemodialysis: Frequent Hemodialysis network (FHN) Trials. Circ. Cardiovasc. Imaging 5, 251–261 (2012).

    Article  PubMed  PubMed Central  Google Scholar 

  43. Block, G. A., Hulbert-Shearon, T. E., Levin, N. W. & Port, F. K. Association of serum phosphorus and calcium × phosphate product with mortality risk in chronic hemodialysis patients: a national study. Am. J. Kidney Dis. 31, 607–617 (1998).

    Article  CAS  PubMed  Google Scholar 

  44. Pellicano, R., Strauss, B. J., Polkinghorne, K. R. & Kerr, P. G. Body composition in home haemodialysis versus conventional haemodialysis: a cross-sectional, matched, comparative study. Nephrol. Dial. Transplant. 25, 568–573 (2010).

    Article  CAS  PubMed  Google Scholar 

  45. Walsh, M. et al. The effects of nocturnal compared with conventional hemodialysis on mineral metabolism: a randomized-controlled trial. Hemodial. Int. 14, 174–181 (2010).

    Article  PubMed  Google Scholar 

  46. Unruh, M. L. et al. Sleep apnea in patients on conventional thrice-weekly hemodialysis: comparison with matched controls from the sleep heart health study. J. Am. Soc. Nephrol. 17, 3503–3509 (2006).

    Article  PubMed  Google Scholar 

  47. Unruh, M. L. et al. Subjective and objective sleep quality in patients on conventional thrice-weekly hemodialysis: comparison with matched controls from the Sleep Heart Health Study. Am. J. Kidney Dis. 52, 305–313 (2008).

    Article  PubMed  PubMed Central  Google Scholar 

  48. Unruh, M. L. et al. Restless legs symptoms among incident dialysis patients: association with lower quality of life and shorter survival. Am. J. Kidney Dis. 43, 900–909 (2004).

    Article  PubMed  Google Scholar 

  49. Unruh, M. L. et al. Sleep quality and its correlates in the first year of dialysis. Clin. J. Am. Soc. Nephrol. 1, 802–810 (2006).

    Article  PubMed  Google Scholar 

  50. Hanly, P. J. & Pierratos, A. Improvement of sleep apnea in patients with chronic renal failure who undergo nocturnal hemodialysis. N. Engl. J. Med. 344, 102–107 (2001).

    Article  CAS  PubMed  Google Scholar 

  51. Jaber, B. L. et al. Impact of short daily hemodialysis on restless legs symptoms and sleep disturbances. Clin. J. Am. Soc. Nephrol. 6, 1049–1056 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  52. Palmer, B. F. Sexual dysfunction in uremia. J. Am. Soc. Nephrol. 10, 1381–1388 (1999).

    CAS  PubMed  Google Scholar 

  53. van Eps, C. et al. Changes in serum prolactin, sex hormones and thyroid function with alternate nightly nocturnal home haemodialysis. Nephrology (Carlton) 17, 42–47 (2012).

    Article  CAS  Google Scholar 

  54. Barua, M. et al. Successful pregnancies on nocturnal home hemodialysis. Clin. J. Am. Soc. Nephrol. 3, 392–396 (2008).

    Article  PubMed  PubMed Central  Google Scholar 

  55. Hladunewich, M., Hercz, A. E., Keunen, J., Chan, C. & Pierratos, A. Pregnancy in end stage renal disease. Semin. Dial. 24, 634–639 (2011).

    Article  PubMed  Google Scholar 

  56. Luders, C. et al. Obstetric outcome in pregnant women on long-term dialysis: a case series. Am. J. Kidney Dis. 56, 77–85 (2010).

    Article  PubMed  Google Scholar 

  57. Berns, J. S. A survey-based evaluation of self-perceived competency after nephrology fellowship training. Clin. J. Am. Soc. Nephrol. 5, 490–496 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  58. Perl, J. & Chan, C. T. Home hemodialysis, daily hemodialysis, and nocturnal hemodialysis: core curriculum Am. J. Kidney Dis. 54, 1171–1184 (2009).

    Article  PubMed  Google Scholar 

  59. Rioux, J. P., Cheema, H., Bargman, J. M., Watson, D. & Chan, C. T. Effect of an in-hospital chronic kidney disease education program among patients with unplanned urgent-start dialysis. Clin. J. Am. Soc. Nephrol. 6, 799–804 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  60. Goovaerts, T., Jadoul, M. & Goffin, E. Influence of a pre-dialysis education programme (PDEP) on the mode of renal replacement therapy. Nephrol. Dial. Transplant. 20, 1842–1847 (2005).

    Article  PubMed  Google Scholar 

  61. Ledebo, I. What limits the expansion of self-care dialysis at home? Hemodial. Int. 12 (Suppl. 1), S55–S60 (2008).

    Article  PubMed  Google Scholar 

  62. Rocco, M. V. et al. The effects of frequent nocturnal home hemodialysis: the Frequent Hemodialysis Network Nocturnal Trial. Kidney Int. 80, 1080–1091 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  63. Pauly, R. P. et al. Utility and limitations of a multicenter nocturnal home hemodialysis cohort. Clin. J. Am. Soc. Nephrol. 3, 1846–1851 (2008).

    Article  PubMed  Google Scholar 

  64. Zhao, L. J. & Wang, T. Attitudes of Chinese chief nephrologists toward dialysis modality selection. Adv. Perit. Dial. 19, 155–158 (2003).

    PubMed  Google Scholar 

  65. Ludlow, M. J. et al. How Australian nephrologists view home dialysis: results of a national survey. Nephrology (Carlton) 16, 446–452 (2011).

    Article  Google Scholar 

  66. McLaughlin, K., Manns, B., Mortis, G., Hons, R. & Taub, K. Why patients with ESRD do not select self-care dialysis as a treatment option. Am. J. Kidney Dis. 41, 380–385 (2003).

    Article  PubMed  Google Scholar 

  67. Pipkin, M. et al. Recruitment and training for home hemodialysis: experience and lessons from the Nocturnal Dialysis Trial. Clin. J. Am. Soc. Nephrol. 5, 1614–1620 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  68. Cafazzo, J. A., Leonard, K., Easty, A. C., Rossos, P. G. & Chan, C. T. Patient-perceived barriers to the adoption of nocturnal home hemodialysis. Clin. J. Am. Soc. Nephrol. 4, 784–789 (2009).

    Article  PubMed  PubMed Central  Google Scholar 

  69. Clark, W. R. & Turk, J. E. Jr. The NxStage System One. Semin. Dial. 17, 167–170 (2004).

    Article  PubMed  Google Scholar 

  70. Junglee, N. A. et al. When pure is not so pure: chloramine-related hemolytic anemia in home hemodialysis patients. Hemodial. Int. 14, 327–332 (2010).

    Article  PubMed  Google Scholar 

  71. Suri, R. S. et al. Burden on caregivers as perceived by hemodialysis patients in the Frequent Hemodialysis Network (FHN) trials. Nephrol. Dial. Transplant. 26, 2316–2322 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  72. Qyinan, P. Home hemodialysis and the caregivers' experience: a critical analysis. CANNT J. 15, 25–32 (2005).

    PubMed  Google Scholar 

  73. Walker, D. R., Inglese, G. W., Sloand, J. A. & Just, P. M. Dialysis facility and patient characteristics associated with utilization of home dialysis. Clin. J. Am. Soc. Nephrol. 5, 1649–1654 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  74. Dimkovic, N. & Oreopoulos, D. G. Assisted peritoneal dialysis as a method of choice for elderly with end-stage renal disease. Int. Urol. Nephrol. 40, 1143–1150 (2008).

    Article  PubMed  Google Scholar 

  75. Rocco, M. V. Nocturnal home hemodialysis: which of your patients should choose this modality? Contrib. Nephrol. 171, 17–24 (2011).

    Article  PubMed  Google Scholar 

  76. Verhallen, A. M., Kooistra, M. P. & van Jaarsveld, B. C. Cannulating in haemodialysis: rope-ladder or buttonhole technique? Nephrol. Dial. Transplant. 22, 2601–2604 (2007).

    Article  PubMed  Google Scholar 

  77. Van Eps, C. L. et al. The impact of extended-hours home hemodialysis and buttonhole cannulation technique on hospitalization rates for septic events related to dialysis access. Hemodial. Int. 14, 451–463 (2010).

    Article  PubMed  Google Scholar 

  78. van Loon, M. M., Goovaerts, T., Kessels, A. G., van der Sande, F. M. & Tordoir, J. H. Buttonhole needling of haemodialysis arteriovenous fistulae results in less complications and interventions compared to the rope-ladder technique. Nephrol. Dial. Transplant. 25, 225–230 (2010).

    Article  PubMed  Google Scholar 

  79. Ball, L. K. & Mott, S. How do you prevent indented buttonhole sites? Nephrol. Nurs. J. 37, 427–428 (2010).

    PubMed  Google Scholar 

  80. Labriola, L., Crott, R., Desmet, C., Andre, G. & Jadoul, M. Infectious complications following conversion to buttonhole cannulation of native arteriovenous fistulas: a quality improvement report. Am. J. Kidney Dis. 57, 442–448 (2011).

    Article  PubMed  Google Scholar 

  81. Moran, J. & Kraus, M. Starting a home hemodialysis program. Semin. Dial. 20, 35–39 (2007).

    Article  PubMed  Google Scholar 

  82. Malmstrom, R. K. et al. Cost analysis and health-related quality of life of home and self-care satellite haemodialysis. Nephrol. Dial. Transplant. 23, 1990–1996 (2008).

    Article  PubMed  Google Scholar 

  83. Agar, J. W. et al. Nocturnal haemodialysis: an Australian cost comparison with conventional satellite haemodialysis. Nephrology (Carlton) 10, 557–570 (2005).

    Article  Google Scholar 

  84. Honkanen, E. O. & Rauta, V. M. What happened in Finland to increase home hemodialysis? Hemodial. Int. 12 (Suppl. 1), S11–S15 (2008).

    Article  PubMed  Google Scholar 

  85. Baboolal, K. et al. The cost of renal dialysis in a UK setting-—a multicentre study. Nephrol. Dial. Transplant. 23, 1982–1989 (2008).

    Article  PubMed  Google Scholar 

  86. Kroeker, A. et al. An operating cost comparison between conventional and home quotidian hemodialysis. Am. J. Kidney Dis. 42, 49–55 (2003).

    Article  PubMed  Google Scholar 

  87. McFarlane, P. A., Pierratos, A. & Redelmeier, D. A. Cost savings of home nocturnal versus conventional in-center hemodialysis. Kidney Int. 62, 2216–2222 (2002).

    Article  PubMed  Google Scholar 

  88. Komenda, P., Gavaghan, M. B., Garfield, S. S., Poret, A. W. & Sood, M. M. An economic assessment model for in-center, conventional home, and more frequent home hemodialysis. Kidney Int. 81, 307–313 (2012).

    Article  PubMed  Google Scholar 

  89. McFarlane, P. & Komenda, P. Economic considerations in frequent home hemodialysis. Semin. Dial. 24, 678–683 (2011).

    Article  PubMed  Google Scholar 

  90. Helantera, I., Haapio, M., Koskinen, P., Gronhagen-Riska, C. & Finne, P. Employment of patients receiving maintenance dialysis and after kidney transplant: a cross-sectional study from Finland. Am. J. Kidney Dis. 59, 700–706 (2012).

    Article  PubMed  Google Scholar 

  91. McFarlane, P. & Komenda, P. Economic considerations in frequent home hemodialysis. Semin. Dial. 24, 678–683 (2011).

    Article  PubMed  Google Scholar 

  92. Goldfarb-Rumyantzev, A. S., Leypoldt, J. K., Nelson, N., Kutner, N. G. & Cheung, A. K. A crossover study of short daily haemodialysis. Nephrol. Dial. Transplant. 21, 166–175 (2006).

    Article  PubMed  Google Scholar 

  93. Connor, A., Lillywhite, R. & Cooke, M. W. The carbon footprints of home and in-center maintenance hemodialysis in the United Kingdom. Hemodial. Int. http://dx.doi.org/10.1111/j.1542-4758.2010.00523.x.

Download references

Author information

Authors and Affiliations

  1. Division of Nephrology, University Health Network, Toronto General Hospital, 200 Elizabeth Street, Toronto, M5G 2C4, ON, Canada

    Karthik K. Tennankore, Christopher T. Chan & Simon P. Curran

Authors
  1. Karthik K. Tennankore
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christopher T. Chan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Simon P. Curran
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

K. K. Tennankore and S. P. Curran contributed equally to researching the data for the article and writing the manuscript. C. T. Chan contributed to discussions of the content review and editing of the manuscript before submission.

Corresponding author

Correspondence to Christopher T. Chan.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tennankore, K., Chan, C. & Curran, S. Intensive home haemodialysis: benefits and barriers. Nat Rev Nephrol 8, 515–522 (2012). https://doi.org/10.1038/nrneph.2012.145

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrneph.2012.145

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing