Assisted Home Dialysis in the United States: New Interest in an Old Idea

Assisted Home Dialysis in the United States: New Interest in an Old Idea: The initial nomination included questions about the comparative effects of staff-assisted and in-center hemodialysis and about the cost-effectiveness of staff-assisted home dialysis. We conducted an initial review of the literature and found marked clinical heterogeneity across programs. We also recognized that confounding due to patient selection would be a pervasive issue (the reasons patients choose home dialysis may be closely related to sociodemographic, functional status, and other health factors that also influence their clinical outcomes). Assisted Home Dialysis in the United States: New Interest in an Old Idea (Rapid Review, released on April 8, 2025) The objectives of this report are to: (a) provide historical context for U.S. policy regarding assisted home dialysis; (b) determine whether the provision of assistance increases home dialysis uptake and, if so, what barriers this intervention addresses in order to do so; (c) compare the effectiveness and safety of assisted and unassisted home dialysis; and (d) synthesize lessons learned about the feasibility, acceptability, patient selection, and duration of assisted home dialysis programs from a review of the international and U.S. literature and from interviews with U.S. leaders in the report.