Welcome to DOMESTICO

The “Dutch nOcturnal and hoME dialysis Study To Improve Clinical Outcomes” (DOMESTICO) is a nation-wide initiative that, with the support of all parties involved (Nefrovisie, NFN, NIV, NVN, Nierstichting, V&VN, industry, health insurers), aims to put home dialysis on the map in the Netherlands by giving an insight into the effects that home dialysis can have on the quality of life and clinical outcomes in the context of financial costs.

In the Netherlands there are over 6500 patients suffering from kidney failure that rely upon dialysis, an intensive and expensive form of treatment. Over the course of the past 10 years, the number of dialysis patients has risen with more than 20% and it is expected this number will keep on rising. The quality of life of patients treated with dialysis is considerably worse than that of healthy individuals. Ideally, patients suffering from kidney failure receive a kidney transplant, but due to a shortage of donors and the rapid aging of the general populace, kidney transplants are proving to be impossible. As such, improving the quality of dialysis treatments and with that the quality of life for patients and limiting the rising costs of dialysis treatment is paramount.

As it stands, well over 80% of dialysis patients are being treated with hemodialysis (dialysis through the vascular system) in a dialysis centre (centrumhemodialysis). The share of patients being treated with any form of home dialysis (peritoneal dialysis, more commonly known as abdominal dialysis) has seen a sharp decline over the course of the last few years, dropping from 33% in 2002 to 18% in 2016. Additionally, there is a noticeable practical variation in the percentage of home dialysis patients per dialysis centre, between 0% and 43% in 2015. This results in a loss of knowledge and experience regarding home dialysis amongst medical professionals. It is also believed there is a strong correlation between the decrease of home dialysis and the worsening quality of life for patients along with rising costs for dialysis treatment. DOMESTICO aims to give an insight into the effects of home dialysis on the quality of life and the clinical outcomes in relation to financial costs.