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New research shows survival benefit with daily dialysis in a nursing home setting
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LAS VEGAS – Patients treated on-site in a nursing home setting with daily home hemodialysis had lower monthly mortality rates and longer median survival when compared to conventional thrice-weekly dialysis, according to new research presented at the 2014 National Kidney Foundation Spring Clinical Meetings. Affiliated Dialysis Centers LLC, an independent dialysis provider based in Illinois, shared the release of clinical data in a Late Breaking Poster Session at the 2014 National Kidney Foundation Spring Clinical Meetings here. Xelay Acumen, a strategy and medical data analytics firm, independently led the data collection and analysis effort, and Dr. Alex Yang, MD, presented the results.
The study used the largest known database of ESRD patients receiving dialysis in the nursing home setting, consisting of nearly 4,000 patients tracked over a 6-year follow-up period. Health status and patient outcomes were compared in nursing home patients receiving daily home hemodialysis vs. conventional thrice-weekly hemodialysis.
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Within this ESRD patient population, nursing home patients typically have even greater health challenges by virtue of their need to be in a nursing home. Thus identifying beneficial treatment paradigms for these patients is a significant clinical priority, according to Yang.
The key findings from this large epidemiological research study were that, compared to conventional thrice-weekly dialysis, patients treated on-site in a nursing home setting with daily home hemodialysis had:
- Generally improved health status
- Lower monthly mortality rates
- Significantly longer median survival (50 months vs 30 months; P<0.001)
"The ADC database is a unique and extremely important research tool, which allows us to study a large population of ESRD patients on dialysis in the nursing home setting and test hypotheses about optimal care and outcomes for this at-risk patient population," said Yang. "The improvements in health status, and particularly in overall survival, in patients treated with daily home dialysis in this study are provocative and suggest the need for a prospective outcomes study."