Older peoples' satisfaction with home-based dialysis

Nephrology (Carlton). 2010 Jun;15(4):464-70. doi: 10.1111/j.1440-1797.2010.01286.x.


Background: The proportion of older people receiving dialysis is rapidly increasing. The typical choice for older patients is between home-based peritoneal dialysis (PD) and clinic-based haemodialysis (HD). Some centres have been successful in encouraging all patients - including older patients - to have home-based self-administered PD or HD.

Aim: To (i) describe the overall satisfaction with renal services among older patients dialysing, or in training, with HD or PD at home; and (ii) examine the relationship between residential distance from the nephrology unit and satisfaction with home-based dialysis.

Methods: Participants were aged 60 years or more; and were either dialysing at home or training for dialysis at home. Two methods of cross-sectional data collection were used: (i) structured quantitative interviews with all participants; and (ii) qualitative interviews with a selected subgroup.

Results: Participants comprised 45 patients on dialysis (94% of 48 eligible). Their average age was 68 years. Duration of dialysis averaged 28 months (range 3-150 months). Ratings of 'very good or excellent' were reported for dialysis treatment by 40 (89%) patients. Patients on dialysis, despite experiencing frustration with dialysis itself, expressed satisfaction across four categories: staff, information provision, involvement in decision-making and confidence in managing dialysis. Dissatisfaction was infrequent.

Conclusion: This pilot study suggests that older patients trained to dialyse at home using PD or HD are highly satisfied with the nephrology service - even when living remote from the nephrology unit. Home-based dialysis is possible in older patients with levels of comorbidity and disease severity as serious as elsewhere.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Chronic Disease
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Services Accessibility*
  • Hemodialysis, Home*
  • Home Care Services, Hospital-Based*
  • Humans
  • Interviews as Topic
  • Kidney Diseases / therapy*
  • Male
  • Middle Aged
  • New Zealand
  • Patient Education as Topic
  • Patient Satisfaction*
  • Peritoneal Dialysis*
  • Pilot Projects
  • Qualitative Research
  • Residence Characteristics
  • Transportation of Patients
  • Treatment Outcome