Trends in home dialysis in Europe over the period 2007 to 2016

Principal investigator: 
Kitty Jager

What is already known about this topic and why is it important?

During the last years, there has been an increasing interest in home dialysis therapies, probably because there is increasing evidence that home dialysis, including peritoneal dialysis (PD) and home hemodialysis (HHD), represent an important alternative to facility hemodialysis that is cost- effective and patient-centered, with a lot of benefits related to patient outcomes not only improving quality of life but also patient survival [1]. However, despite those benefits, both home therapies (PD and HHD) continue to have a low prevalence within worldwide dialysis populations [2]. The majority of patients that present PD failure are transferred to facility HD, and only a few patients transition to HHD, demonstrating that we are missing opportunities to facilitate continuation of treatment at home.

How will you carry out your study?

We will evaluate the trends in the incidence and prevalence of home treatment in the last 10 years to describe current home dialysis options in Europe (including PD and HHD). In addition we will analyse where HHD and PD patients transfer to if HHD or PD is stopped.

How will you decide which patients are included in your study?

Every patient that receives home dialysis (both PD and HHD) or another form of kidney replacement therapy (KRT) during the study period (2007-2016) will be included. Patients who indicated that their data shouldn’t be used for research will not be included.

How many patients do you anticipate including?

We will study trends over a decade in many countries, and therefore include many patients. We estimate to include around 400,000 KRT patients in total (of which 50,000 on HHD or PD) from the ERA-EDTA registry, including around 63,000 patients from England, Wales or Northern Ireland (of which 12,000 on HHD and PD).

For how long will you follow up these patients?

Patients will be followed for a maximum of ten years. 

What new information will your study generate and how will this benefit patients?

This information can be of value to help nephrologists understand that there is still a lot to be done to promote home therapies and that there are still missed opportunities to facilitate continuation of treatment at home. Also it might help to point out that more effective strategies are needed to manage the transition from one home dialysis technique to another home dialysis technique.

Anneke Kramer, Maria Fernanda Slon Roblero, Vianda Stel, Joaquín Manrique Escola


NICE accredited clinical practice guidelines 

Available here

23rd Annual Report

Analyses about the care provided to patients at UK renal centres.

Read the report


A report on the nationwide collection of AKI warning test scores. 

Read the report