Hemodiálisis domiciliaria en España

mauxiliadora.bajo@salud.madrid.org The history of home haemodialysis (HHD) is the history of haemodialysis (HD) itself. In the nineteen-fifties and the start of the nineteen-sixties, the artificial kidney technique successfully used for the first time at the end of World War II by Dr Kolff was perfected and with the advent of the autologous fistula reported by Cimino and Brescia, the first HD programmes could be created as treatment for advanced chronic kidney disease (CKD). Due to the unavailability of adequate hospital facilities and with the idea of treating as many patients as possible, these programmes brought HD to the home. As such, HHD saved many lives in this first stage, with the programmes led by Shaldon in London, Merill in Boston and Scribner in Seattle being notable. Subsequently, HHD continued to grow and reached its peak at the start of the nineteen-seventies at which point 40% of US patients used this method. From this period onwards, we have witnessed a progressive decline for different reasons, amongst which we must highlight the increase in the number and morbidity and mortality of patients, the development of peripheral HD units and changes in the financing policy. Furthermore, at the end of the nineteen-seventies and the beginning of the nineteen-eighties, peritoneal dialysis (PD) was developed, a new dialysis method that simplified the technique and also allowed it to be performed at home.