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

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

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

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

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

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

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

How the Ontario Renal Network (ORN) has been trying to grow home dialysis

ORN started efforts to increase home dialysis use in Ontario in 2012, using a new funding formula based on modality, mandatory informatics, home dialysis coordinator and assisted PD funding, support for urgent start PD, targets for home dialysis rates, a network of clinics committed to home therapies, and frequent leadership meetings. Did they succeed?

Read the abstract » | (added 2021-05-14)

Tags: Home Dialysis, Home Haemodialysis, Peritoneal Dialysis, Hd, Pd

Use of CMS-reimbursed CKD Education Doubles the Likelihood of Home Dialysis

While Medicare has paid for stage 4 CKD kidney disease education (KDE) since 2010, only a tiny fraction have used it—but KDE matters, finds an analysis of 369,968 patients who started dialysis between 2010 and 2014. Just 3,469 (0.9%) had received at least one KDE session, but compared to controls matched for age, gender, ESRD Network and year of dialysis start, they were twice as likely to have started a home dialysis treatment. Concerningly, African American and Hispanic patients were significantly less likely to have received KDE services.

Read the abstract » | (added 2020-12-10)

Tags: Home Dialysis, Kidney Disease Education, Peritoneal Dialysis

Home Dialysis “Virtual Ward” Addresses Gaps in Care Transitions

Following hospital discharge, a procedure, antibiotics, or completion of home training, 2 weeks of telephonic follow-up was provided to 193 PD or home HD patients as a “home dialysis virtual ward” (HDVW). The HDVW identified a median of 1 care gap per patient, with newer patients at higher risk of gaps. Patients were highly satisfied with the HDVW.

Read the abstract » | (added 2019-11-16)

Tags: Home Dialysis, Home Dialysis Virtual Ward, HDVW, Care Gap