BACKGROUND Patients on home hemodialysis (HHD) exhibit superior survival compared with patients on institutional hemodialysis (IHD) and peritoneal dialysis (PD). There is a sparsity of reports comparing morbidity between HHD and IHD or PD and none in a European population. The aim of this study is to compare morbidity between modalities in a Swedish population. METHODS The Swedish Renal Registry was used to retrieve patients starting on HHD, IHD or PD. Patients were matched according to sex, age, comorbidity and start date. The Swedish Inpatient Registry was used to determine comorbidity before starting renal replacement therapy (RRT) and hospital admissions during RRT. Dialysis technique survival was compared between HHD and PD. RESULTS RRT was initiated with HHD for 152 patients; these were matched with 608 patients with IHD and 456 with PD. Patients with HHD had significantly lower annual admission rate and number of days in hospital. (median 1.7 admissions; 12 days) compared with IHD (2.2; 14) and PD (2.8; 20). The annual admission rate was significantly lower for patients with HHD compared with IHD for cardiovascular diagnoses and compared with PD for infectious disease diagnoses. Dialysis technique survival was significantly longer with HHD compared with PD. CONCLUSIONS Patients choosing HHD as initial RRT spend less time in hospital compared with patients on IHD and PD and they were more likely than PD patients, to remain on their initial modality. These advantages, in combination with better survival and higher likelihood of renal transplantation, are important incentives for promoting the use of HHD.

中文翻译：

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家庭血液透析的住院次数减少，技术生存时间延长-来自瑞典肾脏登记处的一项队列研究。

背景技术进行家庭血液透析（HHD）的患者比接受机构血液透析（IHD）和腹膜透析（PD）的患者生存率更高。仅有少数报告比较了HHD与IHD或PD之间的发病率，而在欧洲人群中则没有。这项研究的目的是比较瑞典人群中两种方式的发病率。方法使用瑞典肾脏登记处对HHD，IHD或PD开始的患者进行检索。根据性别，年龄，合并症和开始日期对患者进行匹配。在开始肾脏替代治疗（RRT）和RRT期间入院之前，瑞典住院登记处用于确定合并症。比较HHD和PD的透析技术生存率。结果152例患者开始接受HHD的RRT治疗。这些患者与608例IHD患者和456例PD患者匹配。HHD患者的年住院率和住院天数显着降低。（入院中位数1.7； 12天），而IHD（2.2; 14）和PD（2.8; 20）。HHD患者的年入院率显着低于IHD的心血管诊断和PD的传染性疾病诊断。与PD相比，HHD的透析技术生存期明显更长。结论选择HHD作为初始RRT的患者比接受IHD和PD的患者在医院花费的时间更少，并且他们比PD患者更有可能保留其初始模式。这些优点与更好的生存率和更高的肾移植可能性相结合，是促进HHD使用的重要诱因。