Table 5.

Patient characteristics to consider in selection of either peritoneal dialysis or home hemodialysis as an initial home dialytic modality

Type of DialysisMedical IndicationsPsychosocial DeterminantsPossible Barrier
Peritoneal dialysisResidual renal functionFull-time employment, including childcare at homeHomelessness
EdemaDesire to travelUncontrolled anxiety or psychosis
Suboptimal BPPhobia of needlesPoor hand dexterity, despite adaptations
Mild LV hypertrophyTransportation problemsActive inflammatory bowel disease
Right-sided heart failureAwaiting living donor kidney transplantHistory of complex abdominal surgeries
History of heart failure hospitalization(s)Body image concerns regarding vascular accessAnuria and BSA >2.0 m2
Home hemodialysisUrine volume <250 ml/d and serum phosphorus >8.0 mg/dlFull-time employment, including childcare at homeHomelessness
Ultrafiltration rate >13 ml/kg per h with thrice-weekly IHDDesire to travelUncontrolled anxiety or psychosis
Uncontrolled hypertensionTransportation problemsPhobia of needles
Moderate LV hypertrophyDesire control of treatment scheduleIncreased frailty
Right-sided heart failureBody image concerns regarding PD catheter or distended abdomenBlind or severely visually impaired
Obesity, possibly with obstructive sleep apnea and/or use of CPAP
  • Characteristics were adapted from the Method to Assess Treatment Choices for Home Dialysis (MATCH-D) tool (https://homedialysis.org/match-d; Medical Education Institute, Madison, WI). LV, left ventricular; BSA, body surface area; IHD, in-facility hemodialysis; CPAP, continuous positive airway pressure.