"The Flip” from PD to Home HD: FREE Success Secrets in March!

As all of us in nephrology know, March is National Kidney Month. This year at the non-profit MEI, we are highlighting home dialysis options for kidney failure by offering “The Flip”­—one of our most impactful online SPARK CE courses—for free all this month. Nurses and dialysis technicians who complete the course and post-test can earn one CE credit, and we encourage social workers and nephrology fellows to check out the content as well.

Why Learn About “The Flip”?

PD is a terrific option, especially for those starting a kidney replacement therapy (KRT) journey. It’s relatively easy to learn and do and preserves patients’ autonomy and control over their schedules. But, while I know U.S. patients who have been able to do PD for as long as 18 years, this is quite rare. Per the USRDS Annual Data Report (Figure 3.11a), nearly one in three people who start PD switch to in-center HD within 2 years.

If PD does not work out for whatever reason, the “conveyor belt” of nephrology care too often seems to deliver patients directly to in-center, even though successful PD patients have been:

• Determining their treatment times

• Problem-solving

• Ordering, organizing, storing, and inventorying supplies

• Taking their prescribed medications

• Adjusting their dextrose concentration to their fluid weight gains

• Reporting symptoms and challenges to their care teams

• Otherwise self-managing.

PD can also facilitate employment and travel and the steady energy needed to participate in hobbies and recreational activities. All of these are threatened when the default pathway after PD loses effectiveness is in-center HD.

Some patients may not know that home forms of HD exist (despite 18 years of CMS policy granting patients the right to be told about all of their treatment options and where to get them). Others are exhausted and ill from inadequate PD or peritonitis or intimidated by self-cannulation or wrongly believe their homes must contain water treatment plants or be comprised of shiny steel wipeable surfaces like the clinic. Approaching patients at this vulnerable time, exploring their beliefs and myths, and helping them understand how they will be trained, how they can overcome needle fear, and how home HD can make it possible to keep what they value most can make a home-to-home transition more likely and more successful. THAT’S why we wrote this class.

About SPARK

SPARK (Self-guided Program to Advance Renal Knowledge) is a new kind of continuing education + mentoring for nurses, technicians—and patients that combines wisdom learned from long-term, expert nurses with practical, evidence-based guidance to help those new to dialysis (including home) become skilled more quickly.

All ten 2025 SPARK courses focus on the two most challenging issues facing home therapies: reducing home dialysis dropout and maintaining safety at home. Jenn Ravert, RN, MEI’s Program Director and I developed the courses. Jenn and I both have had family members on dialysis, and Jenn had amazing nursing mentorship for both PD and home HD. It took me a while to persuade Jenn that she is a unicorn, because she has:

• Never had a patient quit training

• Never had a patient quit a home therapy and go in-center during the critical first few months at home

• Never lost a PD patient to in-center HD when PD stopped working

How to Access the Free “Flip” Course

You can view SPARK classes on a Smartphone, tablet, or computer.

1. Visit the MEI Learning Center: https://mei.org/learning-center/

2. Click Learn More at the bottom of the SPARK box.

3. Find and click The Flip class and add it to your cart.

4. View your cart, check out, and watch your email for a link to the course. That’s it!

Take these steps by March 31 to enjoy the course and free CE credit at your leisure. If you like the course—and we hope you will—check out the others and share the link with friends. These courses can be used for corporate or provider training or to boost your own confidence. Happy Kidney Month!