Author's reply

doi:10.1136/bmj.39465.500602.BE

BMJ 2008;336:172-173 (26 January), doi:10.1136/bmj.39465.500602.BE

Letters

Home haemodialysis

Author’s reply

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

Selection bias has an important role, but almost all reportson quality of life have shown the benefits of home haemodialysis(HD), and patients are vocal about the advantages they haveexperienced. Even if survival is no better, surely willing andsuitable patients should have access to a treatment that provides,for example, opportunity for longer or more frequent dialysis,improved quality of life, rehabilitation, and flexibility ofscheduling?

In terms of urbanisation, Australia ranks 19th in the world(91% urbanisation) compared with the UK, which is 20th (90%urbanisation), and New Zealand, which is 32nd (86% urbanisation).¹On the basis of their registries, the rates per million forHD, peritoneal dialysis, and transplantation are also similar—303,85, and 317 in the UK; 330, 88, and 322 in Australia; and 277,176, and 302 in New Zealand.

In New Zealand there used to be little option but home HD if. . . [Full text of this article]

Christopher R Blagg, professor emeritus of medicine

¹ University of Washington, Seattle, WA 98040, USA

blaggc@hotmail.com