Pediatric Applications of Home Hemodialysis

Home hemodialysis (HHD) in children with end-stage kidney disease is a therapy that is only delivered to a small percentage of children who receive chronic dialysis. However, where available as an alternative to conventional peritoneal dialysis or in-center hemodialysis, its use has been found to be safe and effective, with experienced patients/families and providers serving as advocates for the modality. This chapter will review a variety of aspects pertaining to the provision of HHD in the pediatric population based on the limited information that is present in the literature and the experience of the authors. General principles regarding the treatment are reviewed, along with a number of pediatric-specific management issues that are particularly pertinent to children, their families, and the pediatric dialysis team.