A successful home program can improve the quality and extent of life for patients, reduces the cost of provision of therapy to society, reduces the demand for precious and scarce human resources (nursing shortage) and can be highly profitable to the provider, if properly structured. Like most great deeds it requires knowledge, meticulous planning, capital investment and discipline. Certain circumstances such as large distances to a dialysis center and the high cost of fully assisted dialysis, facilitate or even demand development of home dialysis centers. Conversely, the proliferation of dialysis centers in industrialized countries and in large urban areas, the high proportion of underutilized facilities in some regions competing with their development, and the lack of adequate education and exposure of young healthcare professionals in selected countries may interfere with these goals. Improvements in technology for both PD and HD, the recent introduction of specialized and dedicated equipment for home HD, the emphasis on frequent therapies and the proliferation of effective educational initiatives may be the catalysts for the growth and success of home programs.
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