Table 1.

International Home Dialysis Consortium manifesto

All forms of kidney replacement therapy are potentially lifesaving, and a key priority for all countries should be to ensure that kidney replacement therapy is available and affordable for everyone with kidney failure. However, to those who already have access to kidney replacement therapy, home dialysis has special advantages. Providing home dialysis (peritoneal dialysis and home hemodialysis) holds the promise of enhancing patient experience, quality, and equity in kidney failure care by allowing wider global access to kidney replacement therapies.

This manifesto is a public declaration advocating for the promotion of home dialysis globally by:

•Raising awareness of the benefits of home dialysis to people with kidney disease

•Educating all people with kidney failure needing dialysis and their caregivers on all available options, including home dialysis

•Offering home dialysis as part of an integrated patient-centered and value-based care approach for people living with kidney failure in all health care settings

•Enabling people with kidney failure to choose dialysis modality with shared decision-making in all health care settings and with planned or unplanned dialysis start

•Empowering and supporting patients through self-management to have as much responsibility for their dialysis treatment as is appropriate

•Educating and training health care providers, including nephrologists, nurses, primary care providers, dietitians, social workers, and technicians in home dialysis

•Engaging policymakers, payors, and dialysis industry to support home dialysis growth initiatives, adapting actions to local needs and economic realities

•Working with nephrology professional societies, patient advocacy groups, and commercial dialysis providers to develop a global framework to provide home dialysis services

•Creating policy briefs to support advocacy efforts with policymakers

•Creating tools and audit processes to support continuous quality improvement in home dialysis programs

•Facilitating design of reimbursement schemes that are value-based and considering the total costs of delivering dialysis care, including costs of infrastructure

•Ensuring provision of fair and equitable reimbursement for home dialysis, removing financial disincentives and actively promoting optimal patient choice of dialysis modality and location