An overview of haemodialysis

Haemodialysis is the best known of the kidney-replacement therapies used to treat people with both end-stage kidney disease (ESKD), the final stage of chronic kidney disease (CKD) and acute kidney injury (AKI). Kidney-replacement therapies are not a cure for kidney disease, rather they palliate its effects (Mahon et al, 2013).

There are about 4 million people worldwide being treated with a kidney-replacement therapy for ESKD, of whom 69% are on haemodialysis (Bello et al, 2022). In the UK at the end of 2020 68 249 individuals with ESKD were being treated with a kidney-replacement therapy, 35.4% of whom were receiving in-centre haemodialysis and 2% home haemodialysis (UK Renal Registry, 2022); the rest either had a kidney transplant or were maintained on peritoneal dialysis.

While transplant is by far the most prevalent kidney-replacement therapy modality in the UK, with 57% of affected individuals (UK Renal Registry, 2022), haemodialysis is the most common initial therapy. However, haemodialysis is the kidney-replacement therapy that is widely accepted as being the greatest burden both for the patient (Jones et al, 2018) and financially for the NHS, each year costing between £23 403 for home haemodialysis (HHD) and £32 678 for treatment in hospital for patients requiring transport (Roberts et al, 2022).