Dialysis and the Politics of Self-care: The Enduring Effects of Barriers Imposed on Home Dialysis.

Despite its benefits, home dialysis remains significantly underused in the U.S., with rates dropping from 43% to 20% within four years of Medicare's ESRD program.

• Why it matters: This disparity highlights ongoing systemic barriers and inequalities that prevent marginalized and low-income patients from accessing the most suitable dialysis options, risking poorer health outcomes.
• What they did: The study analyzed hundreds of archival records from dialysis organizations, government hearings, and media to trace the political and economic history of home dialysis from the 1960s onward.
• The result: Findings reveal that financial disincentives, industry interests, and socioeconomic barriers have perpetuated underuse, underscoring the need for policies that address these persistent inequalities.