Trump signing home dialysis plan

The Pros and Cons of Trump’s Home Dialysis Plan

Around 125,000 Americans are diagnosed with kidney failure every year, half of them being seniors. Most people attend dialysis centers to receive regular treatment, but the Trump administration is pushing to move the majority to home dialysis. Will it work?

Trump’s home dialysis plan

In July, Trump signed an executive order addressing three goals to manage the treatment of kidney failure:

  • Make sure patients receive kidneys more quickly, 
  • Enable more patients to receive in-home dialysis, and
  • Encourage the development of artificial kidneys. 

The backbone of this plan comes down to saving money. In 2016 alone, Medicare spent $113 billion on kidney disease care. This accounts for more than one-fifth of Medicare’s entire spending for the year. 

But the administration wants to do more than just cut costs; it also wants to increase independence for the 750,000 people who receive regular dialysis treatment. By 2025, the administration hopes to have 80 percent of kidney failure patients receiving home dialysis or a kidney transplant. This is a direct contrast to current numbers, which estimate 88 percent of kidney failure patients receiving treatment at dialysis centers and 12 percent receiving home dialysis. 


Pros of home dialysis

According to Dr. Frank Liu, director of home hemodialysis at the Rogosin Institute in New York City, benefits of home dialysis include:

  • No inconvenience of travel 
  • Shorter recovery time after treatment
  • Individualized therapy
  • More frequent dialysis treatments
  • Improved quality of life

Cons of home dialysis

Home dialysis is not right for everyone. Seniors who should not receive home dialysis include those with:

  • Weak vision
  • Poor fine-motor skills
  • Mental illnesses like depression
  • Cognitive impairment
  • Diabetes
  • Arthritis
  • Heart disease

If patients with these health complications do receive home dialysis, it’s recommended that they have significant assistance from another person when doing so. A recent study revealed that 64 percent of friends, family, and caregivers delivering complex medical care to seniors ranked home dialysis as hard, putting it at the top of the list of difficult care tasks. 

Around one-third of patients who begin home dialysis switch to dialysis centers because of complications or loss of motivation to keep up with the complex regimen.