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New study to test effectiveness of dialysis staff, patient interventions on cardiovascular safety
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The National Kidney Foundation and the University of Michigan are launching a new $6.7 million study, spearheaded by the University of Michigan, to improve cardiovascular safety in hemodialysis patients. The study will include training dialysis staff and patients to make dialysis sessions safer for patients.
The five-year project is funded by the Patient-Centered Outcomes Research Institute (PCORI). The project will be led by Tiffany Veinot, an associate professor in the U-M School of Information and the School of Public Health, and Dr. Rajiv Saran, professor of internal medicine and epidemiology at the U-M Medical School and School of Public Health, and associate director of the Kidney Epidemiology and Cost Center.
About the study
The first intervention will include an education program for professionals, which will include team training, online education, and checklists to identify patients who are becoming unstable during their hemodialysis sessions. The renal care team will be taught to regularly check patients’ fluid status, revisit patients’ fluid removal targets and treatment times more frequently, involve patients in making decisions, make sure the rate of fluid removal stays at a safe level, and respond quickly to session instability.
The second intervention is patient focused. Patients in the study will attend six peer-mentoring sessions, provided by the National Kidney Foundation, that aim to support behavior change. The sessions will encourage patients to eat a healthy, low-salt diet; drink appropriate amounts of fluid; stay at the dialysis clinic for the full length of sessions and longer to allow staff to take fluid out at the right speed; work with doctors and nurses to make decisions about care; and notice and quickly report the dizziness and cramping that could signal hemodialysis session instability.
"This project is exciting because we will be implementing strategies that have been shown to be effective in improving patient outcomes in other diseases," said Jennifer Martin, Vice President of Constituent Services for the National Kidney Foundation. “These interventions give us a chance to determine the best ways to improve safety and well-being for patients undergoing hemodialysis."
The study will be conducted in 28 dialysis facilities across the United States. It will test these interventions to assess whether they improve hemodialysis session stability over a one-year intervention period. -by Rebecca Zumoff