Reflections on the 2025 NKF Spring Clinicals: Addressing Home Dialysis Burnout and Supporting Independence

The 2025 National Kidney Foundation (NKF) Spring Clinical Meetings (SCM25), held in Boston from April 9–13, 2025, brought together several disciplines of kidney professionals to discuss challenges, innovations, research, and best practices in nephrology. These six sessions in particular reflected an interest in home dialysis:

1. Hands On Home Dialysis, April 9 in-person pre-conference (not available On Demand)

2. Overcoming Hurdles to Increase Utilization of Home Dialysis, April 10

3. J. Michael Lazarus Distinguished Lecture: Finding Our Way Home, April 11

4. Advanced Nutrition Interventions for Home Dialysis, April 11

5. Transforming Renal Care: The Essentials of Home Hemodialysis, April 11

6. Keeping Patients Home: Sustaining Successful Independence, April 11

NOTE: you can watch five of these sessions and many others in the NKF SCM25 program through On-Demand Registration until May 29, 2025. Click here and scroll down to see links to register as a member or non-member, as well as a membership link. View presentations on your computer or a mobile device. Use the paper clip tab to download, view, and print speakers’ slides where available.

The Growing Challenge of Care Partner Burnout

Among the many critical topics discussed at SCM25 was patient and care partner burnout and strategies to prevent drop out while sustaining patient independence in home dialysis. These are timely topics as the goal is to increase the number of patients who opt for home-based therapies and retain them on home dialysis.

Home dialysis can offer patients flexibility, autonomy, and a better quality of life. However, the shift of care responsibilities from the clinic to the home also places significant emotional, physical, and logistical demands on patients and care partners when present—note that solo PD and home HD during waking hours are important options as well.

Burnout among home dialysis patients and care partners is a well-documented concern that may manifest as emotional exhaustion, isolation, declining patient outcomes due to fatigue and feeling overwhelmed—and a return to in-center care.

Four Takeaways from SCM25Home Dialysis Sessions

1. The Need to Build a Supportive Care Team

A recurring theme was the importance of an interdisciplinary approach. Successful home dialysis programs integrate nephrologists and nurses as well as social workers, dietitians, technicians, and peer mentors. This team-based model helps distribute the workload, provides patients and care partners with resources, and ensures that both patients’ and care partners’ needs are addressed holistically.

2. The Value of Online Communities and Peer Support

In the April 2025 Home Dialysis Central Newsletter, I shared links to home dialysis posters. One poster (SW-04) by Renata Sledge, PhD, MSW, and Dori Schatell, MS, entitled Well-Being and Self-Management of ESKD Patients in an On-Line Health Community found that participation in the 8100-member Home Dialysis Central Discussion Group on Facebook significantly reduced loneliness and perceived stress among caregivers and patients. The group’s informational and emotional support improved positive affect, demonstrating that virtual communities can be a lifeline for those managing the complexities of home dialysis. Most exciting, this poster was one of only four award winners out of 603 posters submitted!

3. Training and Education for Sustained Home Dialysis

Education remains a cornerstone of home dialysis success. Ongoing training—not just at initiation, but throughout the home dialysis journey was suggested. This includes refreshers on technical skills, troubleshooting, and updates on new equipment or protocols. Empowering patients and care partners with knowledge and confidence can alleviate anxiety and reduce burnout, while enhancing safety and helping patients see what’s in it for them to follow their treatment plans.

4. Recognizing and Addressing Grief and Loss

Another session focused on grieving and bereavement in dialysis, reminding attendees that patients and care partners often experience a sense of loss—of normalcy, time, or personal health. Integrating psychosocial support and providing avenues for care team members, patients, and care partners to process their emotions are vital for sustaining long-term staff, patient, and care partner engagement in home care.

Innovation and Quality Improvement in Home Dialysis

SCM25 featured posters on several quality improvement projects aimed at improving home dialysis programs. One poster entitled Home Therapy Staff Adoption of a Regional Task Force Focused on Patient Retention offered proactive outreach, regular phone check-ins, and tailored interventions when challenges arose. Retention Task Force members served as champions to make sure patients were offered home options. These efforts have shown promise in reducing transitions back to in-center dialysis, which are often precipitated by care partner fatigue or burnout.

Actionable Strategies for Home Dialysis Professionals

Based on the insights from SCM25, here are some practical approaches for home dialysis professionals to support patients and care partners and sustain patient independence:

• Foster interdisciplinary collaboration. Regularly engage the full care team, including social workers, to proactively identify and address patient and care partner stressors.

• Promote Peer Support. Encourage participation in online forums like Home Dialysis Central’s Discussion Group on Facebook and other national or local support groups, which can provide both practical advice and emotional reassurance.



• Prioritize Ongoing Education: Training Once May Not Be Enough. Offer re-training and accessible resources to patients and care partners to ensure that they feel competent, confident, and supported in their roles. Be a cheerleader and remind patients and their care partners, “You can do this.”

• Implement Routine Check-ins. Schedule regular contacts to assess patient and care partner well-being and intervene early if signs of burnout appear. You may prevent burnout by having patient and care partner each complete the Home Dialysis Central Partner Agreement on Tasks for PD (PATH-D-PD) or home HD (PATH-D-HHD) before starting training and as needed when at home as needs change.

  

  

• Advocate for Flexible Respite Options. Provide respite in the home training area

or even in the patient’s home when possible. Connect families with respite care services or short-term assistance to provide caregivers with necessary breaks. The social worker may be able to provide information on home care resources.

Looking Ahead

As home dialysis continues to expand, the well-being of care partners will remain a critical determinant of patient success. The 2025 NKF Spring Clinical Meetings made it clear that sustaining independence at home is not just about the patient. It’s about the entire support system. By prioritizing care partner health, leveraging community resources, and fostering interdisciplinary collaboration, home dialysis professionals can help ensure that patients not only start-but thrive-on home therapies.