Journal Watch - Home Dialysis

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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

  • 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

  • Home Dialysis: Better Outcomes at Lower Costs

    Five years after starting dialysis, the population of Ontario, Canada over age 18 had mean 30-day PD costs 50% lower than in-center HD—and home HD costs 64% lower than in-center. After adjusting for covariates, home HD cost the least and had the highest survival (80%) vs. 52% on PD and 42% on in-center HD.

    Read the abstract » | (added 2019-10-14)

    Tags: Home Dialysis, PD Cost, HD Cost, HD Survival

  • The Role of Frailty in Home Dialysis

    Evaluation of frailty among 109 home dialysis patients revealed a greater than 2-fold increase in risk of a composite outcome that included technique failure and all-cause death. Weakness and weight loss were both linked with higher risk. “Assessing frailty as part of the clinical evaluation for home dialysis therapies may be useful for prognostication and clinical management,” report the authors.

    Read the abstract » | (added 2019-10-14)

    Tags: Frailty, Home Dialysis, All cause Death