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May 1977


Arch Intern Med. 1977;137(5):695-696. doi:10.1001/archinte.1977.03630170091022

To the Editor.—  In his editorial concerning our review article on self-hemodialysis,1 Dr Hull raises several valid questions and considerations, including the heterogeneity of available data and the recent General Accounting Office (GAO) report to Congress (not available at the time of submission of our article) that determined more realistic cost figures for home dialysis of about $15,600 per year.2 We wish to reply to some of his comments and clarify certain considerations that he raised.We purposely entitled our article "Self-Dialysis" rather than "Home Dialysis" because we believe an important issue is how, not just where, the dialysis is performed. Though most of the available data relate to home self-dialysis and in-center limited-care dialysis, we believe that cost can be contained and that the positive psychosocial effects of self-dialysis can be realized by in-center self-dialysis as well as by home self-dialysis. One recent report supports this.3

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