| Abstract: | We are reporting a detailed analysis of our 5 year experience with 78 home hemodialysis patients whose mean age was 39 years. All but 4 of 46 patients who had hypertension during the course of their dialysis were controlled by fluid removal and antihypertensive medications. Only two of eight patients who had positive hepatitis B antigen had clinical evidence of hepatitis. Persistent ascites was found in eight patients; four of these patients responded to either transplantation or intensive hemodialysis. Peripheral neuropathy was progressive in four diabetic patients but remained stable in nine other patients with neuropathy. Roentgenographic evidence of bone disease was found in 67.1 per cent of patients, and 21 per cent of them had fractures. The cumulative survival for the 78 patients was 95.9, 87.6, 68.7 and 53.4 per cent at 0.5, 1, 2, and 3 years, respectively. The major causes of death were cardiovascular, infectious complications and voluntary termination of dialysis. This analysis of our experience in home dialysis has allowed prospective planning in an attempt to improve both the survival and quality of life of home hemodialysis patients. The need for intensive and continuous socioeconomic and psychologic evaluation is discussed. |
