Abstract: FR-PO1077
Assisted Home Hemodialysis in India: Outcomes, Patient Experience, and Nephrologists' Perspectives
Session Information
- Home Dialysis: Modalities, Barriers, Utilization, and Clinical Outcomes
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Kothari, Natasha, K J Somaiya Medical College and Research Centre, Mumbai, MH, India
- Kothari, Jatin Piyush, Nanavati Max Super Speciality Hospital, Mumbai, MH, India
- Billa, Viswanath, Apex Kidney Care, Mumbai, MH, India
- Algeri, Rashmi, Nanavati Max Super Speciality Hospital, Mumbai, MH, India
- Bichu, Shrirang, Apex Kidney Care, Mumbai, MH, India
- Kumar, Rajesh B., Apex Kidney Care, Mumbai, MH, India
- Bodke, Sachin Yadav, Indian Institute of Technology Bombay, Mumbai, MH, India
Background
End-stage kidney disease (ESKD) places a major burden on India's healthcare system. While in-centre hemodialysis (HD) services are expanding, many patients seek home-based HD. Home-Assisted Hemodialysis (HAHD) is a viable, patient-centred alternative but remains underutilised due to barriers faced by patients and nephrologists.
Methods
This retrospective cohort study analysed 640 HAHD patients enrolled at Apex Kidney Care (AKC), India, from 2012-2025. Patients were categorised based on their primary reason for choosing HAHD: convenience or compulsion. Survival outcomes were estimated using Kaplan–Meier analysis and compared between groups. Factors associated with mortality were evaluated using a multivariable Cox proportional hazards model. Patient experience was assessed through a structured HAHD survey (n=54), while nephrologist perspectives were evaluated through a cross-sectional survey (n=202)
Results
Among patients receiving HAHD at AKC, the median age at dialysis initiation was 70 years (IQR 62–77.1 years). Overall, one-year survival of HAHD patients was 62.1% (IQR 57–67%). Patients who chose HAHD for convenience (n=257) demonstrated significantly better one-year survival of 73.8% (IQR 67.7–77.5%) compared to 49.7% (IQR 44.3–54.9%) in those who opted for it by compulsion (n=312) (p<0.005). Older age, female sex, and compulsion-driven selection were independent predictors of mortality. All surveyed patients reported a reduced worry score regarding treatment safety, comfort and quality of care, after initiation of home therapy. Among nephrologists, only 38% actively practised HAHD; however, 88.5% of non-practitioners acknowledged its utility, and 73% considered it a safe modality. Medicolegal concerns were expressed by 68% of nephrologists, though all agreed that these risks could be mitigated through appropriate safeguards.
Conclusion
HAHD is a practical and safe modality for ESKD patients in India, irrespective of whether the choice is driven by convenience or compulsion. Survival outcomes were more strongly determined by patients' baseline health status at enrolment than by the home-based nature of the therapy. The adaptation phase effectively addressed the apprehensions of both patients and nephrologists, underscoring the importance of structured onboarding programs to facilitate broader adoption of HAHD in India.
Acknowledgment
None