Journal Watch - Home HD

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  • Home HD Core Curriculum, 2021

    COVID-19 and policy changes have revived interest in home HD, so nephrologists need to better understand the therapy. This article focuses on factors in successful training and retention, including benefits, pitfalls, challenges, new equipment, prescriptions, and more.

    Read the abstract » | (added 2021-10-13)

    Tags: HHD, Home HD, Training

  • PD and home HD patients less stressed by COVID-19

    Does the social isolation of PD or home HD contribute to a negative psychosical impact from COVID? Apparently not. Forty patients (85% on home HD) responded to a COVID impact survey sent to 98 home HD and 43 PD patients in Toronto. About 80% rated their dialysis satisfaction at 8/10 or higher, had infrequent anxiety or depression, felt dialysis had minimal impact on their lives, and were almost always happy with their family interactions. Just 9% were often worried about caregiver burden. The authors suggest that home is “the optimal form of dialysis.”

    Read the abstract » | (added 2021-10-13)

    Tags: Home HD, COVID 19, Coronavirus

  • Survival with PD vs. Home HD and When to Go Home

    Using a national cohort of 1,993 patients transitioning to home HD and 16,514 to PD between 2007 to 2011, 1,195 home HD were matched to 1,195 using propensity scores and adjusting for demographics, comorbidities, dialysis duration, and BMI. Those on home HD had significantly better survival (9.6 vs. 12.9 deaths per 100 patient-years; p<0.001). However, when patients switched to PD within the first 12 months of starting dialysis, survival was comparable between PD and home HD: patients who transitioned after 12 months had an 83% higher risk of death.

    Read the abstract » | (added 2020-02-19)

    Tags: Home HD, PD, Comorbidities, Dialysis Duration, BMI, Survival

  • Home HD: Hospitalizations and Technique Survival

    In a Swedish registry study, patients initiating PD (n=456), home HD (n=152), and in-center HD (IHD; n=608) were matched by age, sex, comorbidity, and start date. Patients using home HD had significantly lower hospital admissions and days than those doing PD or IHD (1.7, 12 days vs. 2.8, 20 days and 2.2, 14 days respectively). Home HD patients also had significantly fewer admissions for cardiovascular diagnoses or infectious disease, as well as significantly longer technique survival.

    Read the abstract » | (added 2020-01-09)

    Tags: PD, Home HD, In center HD, Hospital Admissions, Cardiovascular Diagnosis, Infectious Disease, Technique Survival

  • Home HD After PD Failure May Lead to More Transplants, Lower Mortality

    Since PD failure can lead to hospitalization and death in those who switch to standard in-center HD (ICHD), would outcomes improve with home HD? A new analysis found 521 patients in the USRDS data who made the change. Compared to matched ICHD patients, the chance of transplant was nearly double (21% vs. 10.6%), while survival of home HD patients was 89.1% at 1 year and 80.5% at 2 years.

    Read the abstract » | (added 2018-08-13)

    Tags: PD Technique Failure, ICHD, Transplant, Home HD, Lower Mortality

  • Standard Kt/V urea Targets Less Useful for Home HD

    When patients do home HD more often than three times a week, do the Kt/V urea targets still predict outcomes? Not all that well, suggests a new study. Multivariate regression analysis of 109,273 standard in-center HD patients compared to 2,373 home HD patients found that while a lower Kt/V urea (<2.1) did predict higher blood pressure in both groups, it did not predict metabolic control in either group. For those on home HD, a low Kt/V did not predict hospitalization, mortality, or technique failure, though it did for in-center patients. The authors concluded that the current Kt/V urea targets “have limited utility” for home HD.

    Read the abstract » | (added 2018-02-15)

    Tags: Home HD, Kt/V Urea Targets, Metabolic Control

  • Nephrology Fellows Need Home HD Training & Experience

    Home HD offers research and quality improvement topics for fellows, but lack of training is a barrier to patient use of this option. Fellows should attend lectures and receive at least 6-12 months of outpatient clinical exposure that includes transitioning three or more patients to home, argues a new op ed. Having a passionate home HD expert and advocate is essential, as is exposure to home HD nurses.

    Read the abstract » | (added 2018-02-15)

    Tags: Home HD, Outpatient Clinical Exposure

  • Connecting Home HD Patients to Care Teams Reduces Dropout

    Nx2me is a telehealth platform that allows patients who use NxStage machines for home HD to send data to and communicate with their care teams. Compared to matched controls, 606 Nx2me users were more likely to successfully complete training and less likely to drop out of home HD.

    Read the abstract » | (added 2018-01-11)

    Tags: Nx2me, Telehealth, NxStage Machines, Home HD