Recent Trends in Home Hemodialysis Therapy in Japan.

BACKGROUND: Home hemodialysis (HHD) is rapidly becoming more widespread because HHD programs enable patients to receive a sufficient dialysis dose to improve their quality of life and survival rate without compromising their lifestyle.

SUMMARY: Although HHD in Japan has a long history, the 529 dialysis patients being treated with HHD as of the end of 2014 account for only 0.17% of all dialysis patients. HHD is well indicated for patients who are younger, male, and nondiabetic. The major HHD dialysis programs were provided 4-6 times per week for 3-5 h per session, and 79.3% of HDD patients showed treatment adequacy with a hemodialysis product >72. Key Messages: To expand HHD in Japan, several challenges must be overcome. First, the government should clearly state that home medicine is the way forward and incentivize facilities to provide, and patients to receive, HHD. Second, we need to establish a typical business model for HHD to include the supply of medical devices, collection of disposals, and development of a special machine for HHD.