Why many kidney patients are still choosing hospital dialysis

Leah McLaughlin, a research fellow in health services at Bangor University, explores how the NHS can help more people access care at home

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EVERY week, thousands of people with kidney disease in the UK spend long hours in hospital receiving lifesaving dialysis.

For many, this means travelling to a kidney unit three times a week and sitting through sessions that last four hours or more. It’s a huge commitment that affects people's ability to work, travel and maintain a normal social life.

But for many with kidney failure, there's another option: dialysis at home. It's more flexible, often less disruptive and, in the long run, more cost-effective for the NHS. So why do most people still choose hospital dialysis?

A parliamentary summit in May reflected on how to make dialysis more accessible to patients at home. My colleagues and I published research on this topic in 2019. Working in partnership with people who have kidney disease, their families, NHS staff, dialysis providers and kidney charities, we explored the barriers to home dialysis, and how to overcome them.

People with kidney failure need either a transplant or regular dialysis to filter waste from their blood. Despite NHS guidance that at least 20% of people on dialysis should be supported to have this treatment at home, this target isn’t being met in many parts of the UK.

Our research team, which included people who had experienced dialysis, held discussions with 50 people from across Wales. Many told us that hospital dialysis was presented by healthcare staff as the default option. For those who had not yet come to terms with needing dialysis, or who had delayed planning due to the unpredictable nature of kidney disease, hospital treatment felt like the path of least resistance.