In Case You Missed It! March 2024

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

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

Home Hemodialysis (HHD) Recent Findings

Patient Survival with Extended Home Hemodialysis Compared to In-Center Conventional Hemodialysis

Patient survival, technique survival, hospitalization, and clinical, laboratory, and medication changes were retrospectively analyzed in 349 HHD patients treated with longer session duration, most on nocturnal, were compared to 1,047 concurrent, propensity-score matched in-center hemodialysis patients, using 47 variables with a long-term follow-up.

Peritoneal Dialysis Recent Findings

Trends in Automated Peritoneal Dialysis Prescriptions at a Large Dialysis Organization from 2015 to 2019

Prescription data was examined in 11,659 patients who initiated automated PD between 2015 and 2019. PD prescription changes and practices, from initiation to month 4, for both daytime and nighttime, are described.

Inpatient Peritoneal Dialysis Catheters Placed Across the United States During a 3-Year Period: Lessons Learned from 15,000 Patients

Peritoneal catheter insertions from 2017 to 2019, categorized by patient characteristics and placement technique (laparoscopic, fluoroscopic, and open surgical) were analyzed.  Six-month readmissions, mortality, and catheter-specific outcomes were assessed.

Service Utilization Patterns and Direct Medical Costs of Hospitalization in Patients with Renal Failure Before and After Initiating Home Peritoneal Dialysis

Average hospital utilization and direct healthcare hospital costs, measured in international dollars, were estimated in 749 patients with kidney failure before and after initiating PD in 2014 at a Mexican hospital. Costs were categorized by type of service utilization: inpatient emergency room stays, inpatient services at internal medicine or surgery, or hospital PD, and between non-home PD patients and home PD patients.

Home Dialysis (HHD & PD) Recent Findings

The Burden of Home Dialysis: An Overlooked Challenge

Authors explored aspects of home dialysis that are associated with patient and care partner burden of therapy. They also emphasize the need for increased awareness of the challenges, and potential strategies to improve home dialysis and/or care partner burden.

Pregnancies in Women with Kidney Failure on Home Dialysis in the United States

The study analyzed USRDS data from 26,387 women between the ages of 15 and 49 receiving maintenance home dialysis from 2005 to 2018. Overall pregnancy rates were stratified by USRDS by age group (15-19, 20-24, 25-29, 30-34, etc.), race/ethnicity, prior nephrology care, neighborhood poverty level, and neighborhood rurality. Fetal outcomes, by home dialysis modality, were compared.

End-Stage Kidney Disease Recent Findings

Availability and Quality of Dialysis Care in Rural Versus Urban U.S. Counties

County-specific Centers for Medicare & Medicaid Services Dialysis Facility Compare data was sourced and cross-referenced using the CDC PLACES (adult diabetes prevalence) dataset to approximate high-need dialysis communities and whether quality dialysis services were established and available. Whether or not there was a dialysis facility in the county, and if the facility offered HHD, PD, a late shift, and the facility’s average star rating were considered.

Inferring Personal Intake Recommendations of Phosphorus and Potassium for End-Stage Renal Failure Patients by Simulating with Bayesian Hierarchical Multivariate Model

Investigators collected dietary intake data and corresponding lab data in 37 patients and used a Bayesian hierarchical, multivariate model to generate personalized dietary intake regimens, with substantial variations in phosphorus and potassium intakes recommended for each patient based on general guidelines, and by modality; either hospital hemodialysis, home hemodialysis, or PD.

A Transplant-Inclusive Value-Based Kidney Care Payment Model

Proposal for a kidney transplant-inclusive, end-to-end payment model, that would take effect after the current kidney value-based care models end in 2026. This proposed, value-based, episode-of-care model would include risk-based reimbursement to incentivize reducing transplant-related expenditures for system-level interventions, versus incentivizing reduced total-cost-of-care.

APM5027 Rev.A

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