Journal Watch
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
Home vs. In-center HD Outcomes from a Matched Cohort
After adjusting for BMI, smoking, race, and comorbidities, home HD came out ahead of in-center HD when 181 home HD patients were matched to 413 using in-center HD. With home HD, the risk of death was significantly less, and phosphate levels were significantly lower. There were no major differences in transplant rates, graft survival, hemoglobin, calcium, or PTH levels.
Read the abstract » | (added 2021-06-15)
Tags: Dialysis Modality; End stage Kidney Disease; Haemodialysis, Hemodialysis, Home Haemodialysis, Home Hemodialysis, Mortality
In-center Nocturnal HD Improves Quality of Life vs. Standard In-center HD
A small prospective cohort study of standard in-center HD patients (n=36) who switched to in-center nocturnal HD compared baseline health-related quality of life to levels 12 months later. Among the 24 who completed the study and permitted follow up, the mental component score increased by 7.1 points, and improvements were seen in several domains.
Read the abstract » | (added 2021-06-15)
Tags: In center Nocturnal Hemodialysis, Health related Quality Of Life, End stage Renal Disease, KDQOL 36
U.S. nephrology fellows’ perceptions of their home dialysis training
To grow home therapies, we must have clinicians who are trained in PD and home HD. A survey of 110 nephrology trainees suggests that we are not there yet. Of the 76 respondents, most were moderately confident about PD principles—but not urgent start PD or catheter insertion. Confidence around home HD was low.
Read the abstract » | (added 2021-05-14)
Tags: Home Dialysis, Hd, Home Hemodialysis, Hdd, Peritoneal Dialysis, Pd
Measure needed for life participation in PD
A literature review and metaanalysis of 301 studies identified 42 measures to assess life participation, but most were used in just one study or were not specific to PD. The authors conclude that a new measure is needed.
Read the abstract » | (added 2021-05-14)
Tags: Life Participation, Peritoneal Dialysis, Pd
The impact of low magnesium levels on heart disease deaths on PD
Hypomagnesemia is linked with all-cause mortality in HD—but, what about PD? A study classed 1,004 blood tests from PD patients measuring magnesium into one of three groups: <0.7 mmol/L, 0.7-1.2 mmol/L, and >1.2 mmol/L. Those in the lowest magnesium group did have a higher risk of death from both heart and non-heart causes.
Read the abstract » | (added 2021-05-14)
PD vs. standard HD for health-related quality of life, and employment
A DOPPS study analyzed data from 7,771 standard in-center HD and PD patients in six countries. Those from Japan had the highest physical functioning and employment rates—with PD better than HD. The U.S. had the highest mental functioning and lowest employment rates. During one year, physical and mental function did not change much.
Read the abstract » | (added 2021-05-14)
Tags: Kidney Disease, Employment, DOPPS
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
Home Dialysis Care Experience instrument
A new patient-reported experience measure for PD and home HD has been developed, based on a structured literature review, focus groups, interviews, and then cognitive testing. The 26-item measure covers 16 domains in six areas: communication and patient education, care team concern and helpfulness, care team proficiency, patient-centered care, care coordination, and personalized care.
Read the abstract » | (added 2021-04-16)
Tags: Hemodialysis, Hd, Peritoneal Dialysis, Pd
Patients Who Want Autonomy More Likely to Choose PD
A national survey had 630 HD and PD patients respond to a survey about internal locus of control (ILOC) and an interest in treatment responsibility (ITR). The responding PD patients were younger and had significantly more desire both for control in general and interest in treatment responsibility in particular.
Read the abstract » | (added 2021-04-16)
Tags: Peritoneal Dialysis, Pd, Hemodialysis, Hd, Decision making