Abstract
Home dialysis might be expanded because Japan has to face a society of more aged and less young people, but home hemodialysis (HHD) and CAPD have not become popular. Home dialysis can be an ideal option for patients who value their independence and need to fit in their treatments while working full-time. Also, CAPD patients can maintain residual renal function longer than hemodialysis patients. On the other hand, self-management under home dialysis puts a severe strain to patients, and it is difficult for these patients to do the same amount of work as before. Long-term CAPD increases the risk of encapsulating peritoneal sclerosis (EPS). Patients with endstage renal disease (ESRD) due to diabetic nephropathy and benign-nephrosclerosis, whose number is rapidly increasing, are not positively recommended for HHD and CAPD. Moreover, CAPD patients who require extensive care are not accepted for long-term admission to hospital. In Japan, medical expenses are the same for both HD and CAPD. If the medical expenses for CAPD goes down in price and the savings are passed on to CAPD patients, a breakthrough will come true to resolve the problem of the increasing number of aged ESRD patients.
