Home hemodialysis with Tablo may help patients achieve target ultrafiltration rates
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KANSAS CITY, Mo. — Research from two studies presented at The Annual Dialysis Conference suggested at-home use of Outset Medical’s Tablo hemodialysis system 4 days per week may improve sleep quality, with patients also demonstrating a high adherence to therapy and achieving target ultrafiltration rates.
“The Tablo Hemodialysis System is an all-in-one system indicated for use in clinic and hospital settings recently studied in the home environment,” Michael Aragon, MD, of Outset Medical, and colleagues wrote in a poster abstract. “Features include an integrated water purification system and on-demand dialysate production.”
As part of their investigational device exemption trial, researchers sought to assess sleep quality of patients, as well as to determine their average ultrafiltration rate and treatment adherence, when undergoing hemodialysis with Tablo four times per week. All patients (consisting of 15 prior in-center patients and 13 prior in-home patients) were prescribed to receive dialysis with Tablo for 8 weeks in center, then 4 weeks of transition, followed by 8 weeks at home.
For the sleep quality portion, patients completed a baseline sleep questionnaire, which determined how many days per week they had difficulty falling asleep, staying asleep or had trouble feeling rested. Data, which were compared between the in-center period and at-home period, showed patients reported sleep-related symptoms less often when receiving at-home therapy. For instance, 38.5% of prior in-home patients and 33.3% of prior in-center patients reported waking up several times a night at baseline vs. 24% and 21.5%, respectively, when utilizing the Tablo four times per week at home.
In the second abstract, the researchers noted patients who have ultrafiltration rates of more than 10 mL/kg/hr during dialysis may have greater risk for both all-cause and cardiovascular mortality. Comparing treatment adherence and ultrafiltration rates between the in-center and at-home periods, they found adherence to therapy increased from 96% in center to 99% with the Tablo at home. Furthermore, most patients achieved an average ultrafiltration rate of less than 8mL/kg/hr when utilizing the home-based therapy.
Taken together, these findings led researchers to conclude home hemodialysis therapy with Tablo four times per week may improve sleep quality for patients with ESKD, as well as help them “achieve a high adherence to therapy and ultrafiltration rates previously associated with improved outcomes.” - by Melissa J. Webb
References:
Aragon M, et al. Improved quality of sleep on 4-day per week home hemodialysis with Tablo.
Aragon M, et al. High treatment adherence and ultrafiltration rates on 4-day per week home hemodialysis with Tablo.
Both presented at: The Annual Dialysis Conference; Feb. 8-11, 2020; Kansas City, Missouri.
Disclosure: Healio Nephrology was unable to determine relevant financial disclosures prior to publication.