Journal Watch - Home Dialysis
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Home Dialysis in Finland
Prevalence of home dialysis has dropped in the past decade in Finland, despite its better survival compared to in-center HD. Semi-structured surveys for nephrologists, nephrology nurses, and patient associations endeavored to understand why. Nursing shortages and patient comorbidities received wide agreement as barriers, and clinicians believed that starting in-center reduces the odds of switching to home treatments later. For patients, financial burdens and impact on care partners were critical, as was “bringing hospitals home” or living in small spaces.
Read the abstract » | (added 2025-03-13)
Tags: Home Dialysis, Survival, Modality, Barriers
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Home Dialysis + Person-centered Care
A scoping review identified 9,443 articles about the intersection of person-centered interventions (PCI) and home dialysis. The 16 that met the inclusion criteria included 13 PCIs; eight to involve patients in modality choice, six to involve them in their treatment, and one to involve patients in post-treatment-choice decisions. Five found a correlation between a PCI and the number of patients using home dialysis.
Read the abstract » | (added 2025-03-13)
Tags: Home Dialysis, Person centered Interventions, Modality Choice
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Home Sweet Home Dialysis
Home Sweet Home (HSH) is a new Canadian program where current home dialysis patients share their lived experiences with prospective patients in a home-like setting. Of 291 participants between 2015 and 2019, 92% were interested in a home modality, noting that they valued patients’ real-life perspective and felt less anxious. At follow-up, 25% were doing home dialysis, 24% had a transplant, and the remaining survivors were dialyzing in-center.
Read the abstract » | (added 2025-02-14)
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Home Dialyzor Telehealth Preferences
A small study (n=34) that included surveys and 21 interviews found that 70% of home dialysis patients preferred face-to-face home visits, while 68% had previously had telehealth visits. Knowledge of telehealth was the main perceived barrier, while convenience and flexibility were the main benefits. Non-English speaking patients were at a disadvantage for telehealth.
Read the abstract » | (added 2023-07-17)
Tags: Home Dialysis, Home Visits, Telehealth
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PD vs. Home HD for Severe Infections
In a Finnish study of 536 patients using home dialysis, the risk of a severe infection (C-reactive protein of 100mg/L or higher) in year 1 of CAPD was 35%, APD was 25% and home HD was 11%. Over a 5-year period, compared to home HD, the hazard ratio of severe infection for APD was 2.2 and for CAPD, 2.8. PD peritonitis accounted for the difference.
Read the abstract » | (added 2023-07-17)
Tags: Home Dialysis, Severe Infection, C reactive Protein, CAPD, APD, HD, Home HD, PD Peritonitis
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Structured CKD Education More Than Tripled Uptake of Home Therapies
In a matched retrospective cohort study, 2,398 CKD patients who attended a single 90-minute education program were pair-matched with others who did not. Compared to controls, those who attended the session were significantly more likely to be doing home dialysis (38.5% vs. 12.6%) and to be using a permanent access (57.9% vs. 33.8%). Hospitalization rates were 38% lower as well, and education-attendees had lower first-year mortality.
Read the abstract » | (added 2022-07-13)
Tags: CKD, Education Program, Home Dialysis, Permanent Access, Hospitalization Rates, First year Mortality
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Home Dialysis Associated with Higher Patient Activation
Increased patient activation is linked with better health outcomes. Among 182 people starting dialysis who took the Patient Activation Measure (PAM) survey at month 1 and month 4, those who did home dialysis tended to have higher PAM scores than those who did in-center treatments.
Read the abstract » | (added 2022-07-13)
Tags: Patient Activation, Health Outcomes, Dialysis, Patient Activation Measure, PAM, Home Dialysis
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Home-to-Home Dialysis Transition
When PD or home HD do not work out, people tend to end up in-center. In one clinic, of 911 home dialysis patients with technique failure, just 28 made a home-to-home transition over a 24-year period. Technique and patient survival were comparable, though hospitalizations and temporary in-center HD were common.
Read the abstract » | (added 2022-05-12)
Tags: Home Dialysis, In center, Technique Failure, Home to home Transition
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Italians Improve on Daily Home HD
As in the U.S., the Italian Ministry of Health has home dialysis as a primary objective. In a 2-year study of seven people switched to six times per week daily home HD, significant improvements began to appear almost immediately. After 3-6 months, bone mineral balance and blood pressure were better, PTH levels and use of phosphate binders dropped, and the participants needed less rhEPO.
Read the abstract » | (added 2021-11-12)
Tags: Home Dialysis, Daily Home HD, RhEPO, Mineral Balance, Blood Pressure, PTH Levels
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Funding U.S. Dialysis Innovation: The Role of TPNIES
CMS is expanding reimbursement to encourage use of home treatments under the transitional add-on payment for new and innovative equipment and supplies (TPNIES). An up to 26% reimbursement to clinics requires machines to be eligible under the substantial clinical improvement (SCI) criteria—but these have not been adapted for home dialysis and may not be suitable.
Read the abstract » | (added 2021-06-15)
Tags: Home Dialysis, Transitional Add on Payment For New And Innovative Equipment And Supplies, TPNIES