Abstract：
In 2023, home hemodialysis (HHD) is a dialysis modality used safely and performed independently at home by patients with chronic kidney disease (CKD). HHD requires adequate training and appropriate installation which includes the management of medical devices and consumables in the environment of each patient. According to each patient, HHD can be performed daily, every other day or overnight (nocturnal). The duration of the session varies from a few hours (less than three) during the day to several hours (six to ten) during the night. Over the past 10 years, we have been part of a revival in HHD with the availability of small machines better suited to homes and patients. Few controlled interventional studies and extensive registry data support the hypothesis that increase of frequency and duration of dialysis is associated with improved patient survival, cardiovascular risk profile, and quality of life. In addition to the physiological benefits of HDD, there are clear quality of life, social and economic benefits. There are, however, some disadvantages of HHD, including the application and time required for training, the risk of burnout, and the reluctance to \"hospitalize\" at home. Overall, these limits can be anticipated and overcome by appropriate training, multidisciplinary monitoring, and a dedicated organization. This review recalls the main clinical advantages of HDD related to both physiology and lifestyle as well as the main obstacles and proposes perspectives to guarantee its development. © 2022 Société francophone de néphrologie, dialyse et transplantation. Published by Elsevier Masson SAS. All rights reserved.
摘要：
2023年，家庭血液透析（HHD）是慢性肾病（CKD）患者在家中独立安全使用的透析方式。HHD需要足够的培训和适当的安装，包括管理每个患者环境中的医疗设备和消耗品。根据每个病人，HHD可以每天进行，每隔一天或过夜（夜间）。会议的持续时间从白天的几个小时（少于三个小时）到晚上的几个小时（六到十个小时）不等。在过去的10年里,我们已经成为HHD复兴的一部分，提供更适合家庭和患者的小型机器。很少有对照介入研究和广泛的登记数据支持以下假设：透析频率和持续时间的增加与患者生存率的提高有关。心血管风险概况，和生活质量。除了HDD的生理益处，有明确的生活质量，经济效益和社会效益。有,然而,HHD的一些缺点，包括申请和培训所需的时间，倦怠的风险，不愿在家“住院”。总的来说,这些限制可以通过适当的培训来预测和克服，多学科监测，一个专门的组织。这篇综述回顾了HDD与生理和生活方式有关的主要临床优势以及主要障碍，并提出了保证其发展的观点。©2022法国法语国家集团，透析et移植。由ElsevierMassonSAS发布。保留所有权利。
