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Practice of home hemodialysis in dialysis clinic.

The number of dialysis patients in Japan was approximately 300,000 at the end of 2010. Among these patients, however, the number of those undergoing home hemodialysis (HHD) was only 279 (<0.1 %). It is clear that HHD is a superior treatment to in-center hemodialysis, because of the unlimited frequency and time of HHD, as well as its association with a higher QOL and greater improvement in complications (e.g. hypertension). However, there are still many challenges to be overcome in order to disseminate HHD. It has yet to become widely available, partially because of low-level recognition among dialysis patients and healthcare workers providing dialysis, rather than problems regarding medical technologies and the economy. Of the 16 HHD patients in this center, 10 are practicing overnight hemodialysis, and they are extremely satisfied with its advantages: prolonged treatment yields a better health condition, the dialysis time seems shorter than 1 h by practicing it during hours that include the sleeping time, their complexion becomes as favorable as that of healthy persons, their itchy sensation resolves, they feel as if their physical conditions have returned to a normal level, and their QOL surprisingly increases. Training for HHD is conducted in the dialysis unit along with other patients receiving dialysis treatment (three times a week). Such training lasts for approximately 3 months, during which time patients continue their work. After the initiation of HHD at home, patients and their caregivers can contact our center staff with a cellular phone at any time so they do not need to feel anxious. We hope that many patients will practice HHD in order to resume an active daily life.