In Case You Missed It! April 2024

This month’s newsletter highlights a selection of recently published peer-reviewed articles that piqued our interest, grouped by their most relative modality:

Home Hemodialysis (HHD)
Peritoneal Dialysis (PD)

We hope you find these recent findings useful and of value in your day-to-day practice.

Home Hemodialysis Recent Findings

Patient Training and Patient Safety in Home Hemodialysis

The authors review the epidemiologic data characterizing the safety of home hemodialysis (HHD) as compared with conventional in-center hemodialysis and how patient training affects safety, while emphasizing the surprising lack of literature surrounding these topics. The authors present considerations for the structure and organization of HHD patient training programs, outline a safety and quality assurance framework to further optimize patient safety for HHD programs, and address methods of monitoring and reporting adverse events.

Home Dialysis (HHD & PD) Recent Findings

Home Dialysis in Patients with Cardiovascular Diseases

Kidney failure and cardiovascular disease often present ubiquitously in day-to-day clinical practice. Home hemodialysis and peritoneal dialysis may offer a greater benefit to dialysis patients at higher risk of cardiovascular disease than conventional in-center hemodialysis, particularly with reported associated improvements in cardiovascular markers and bone and mineral metabolism. This review article describes the benefits and potential risks associated with home dialysis in dialysis patients with comorbid cardiovascular disease and the critical importance of home dialysis as a component of health equity.

Cardiovascular Outcomes in Patients on Home Hemodialysis and Peritoneal Dialysis

Investigators assessed and compared cardiovascular outcomes in 68,645 incident home dialysis (HHD and PD) patients from 2005 to 2018, using USRDS data linked to Medicare claims. Variations in PD and HHD treatment regimens were not included in the analysis. For example, the HHD group included short daily, nocturnal, every other day, and conventional home HD regimens. Similarly, PD included CAPD, CCPD, APD, wet or dry day regimens. The analysis also employed measures to identify and exclude home dialysis patients residing and/or receiving treatment in a nursing facility versus a private residence, to adjust for confounding

Evaluation and Measurement Properties of a Patient Reported Experience Measure for Home Dialysis

A new, 26-item, Home Dialysis Care Experience (Home-DCE) survey was fielded with 1,372 home dialysis patients (peritoneal dialysis or home hemodialysis). Response rates to at least one survey (36%; 495 patients) were assessed and calibrated for floor and ceiling effects and included composite scores evaluations based separately with patient and facility characteristics, at two separate time points, to evaluate usefulness.

APM5040 Rev.A

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