A Cochrane review included 1 single cross-over RCT (enrolling 9 participants) that compared home haemodialysis (long hours: 6 to 8 hours, 3 times/week) with in-centre haemodialysis (short hours: 3.5 to 4.5 hours, 3 times/weeks) for 8 weeks in prevalent home haemodialysis patients. Home haemodialysis reduced 24 hour ambulatory blood pressure and improved uraemic symptoms, but increased treatment-related burden of disease and interference in social activities.
A technology assessment report on haemodialysis at home was abstracted in the Health Technology Assessment Database . Four systematic reviews, one randomised crossover trial and 22 comparative observational studies were found for review. The overall quality of the primary studies was low with highly selected patient groups, and the majority of the studies were pre-1990. Most studies found patient survival to be at least equal or better for home haemodialysis compared with hospital dialysis. Some patients might have undertaken more frequent dialysis at home than is the norm in hospitals. A cost model prepared for this review indicated that with threetimes-weekly dialysis, the annual cost of home haemodialysis was always less than haemodialysis in a satellite unit or hospital. However, lifetime treatment costs for an identical group of patients will be higher for home haemodialysis if the treatment is beneficial and leads to longer survival.