Missing facts, different countries

doi:10.1136/bmj.39465.485972.BE

BMJ 2008;336:172 (26 January), doi:10.1136/bmj.39465.485972.BE

Letters

Home haemodialysis

Missing facts, different countries

The first 150 words of the full text of this article appear below.

Blaggs states that home haemodialysis (HD) is cost effective.¹In the United States, where there is less likelihood of receivinga cadaveric transplant than in the United Kingdom (45% v 30%),the economics are different. In the United Kingdom the breakeven point on the set up and running costs of home HD v in-centreHD is about two years. Analysis of data from the UK Renal Registryshows that within 20 months of starting, half of the patientsreceiving home HD would have received a kidney transplant. Thismakes the cost neutral point towards 3-4 years.

It will always be difficult to show that home HD improves survivalas patients on the home HD programme in any renal unit are alwayshighly selected. They are unlikely to have any comorbid conditionsand have good fistulas (not central lines). It is difficulteven with age matching to allow for all . . . [Full text of this article]

David Ansell, director, UK Renal Registry

¹ Southmead Hospital, Bristol BS10 5 NB

david.ansell@nbt.nhs.uk