Home Dialysis News

By Sharon Pienkos, BS; Sumi Sun, MPH ; Sheila Doss-McQuitty, BSN, RN, CNN, CCRA;  Thomas Czajkowski, BS;  Brigitte Schiller, MD, FACP

SEATTLE––Should we blame the untrained nephrologists or the medical directors that are ambivalent? The dialysis providers focused on paying off their bricks and mortar? Patients not able to handle intensive dialysis or the cost of home renovations? Inconsistent guidance from Medicare's fiscal intermediaries on payment for more frequent dialysis? Bad surgeons? The Annual Dialysis Conference is, in many respects, a preacher talking to their choir. The program is diverse, but those who attend this meeting that was built on advocating for peritoneal dialysis 33 years ago, and later home hemodialysis, tend to be advocates for home dialysis. As long as dialyzing at home remains an underdog, however, the ADC will work on ways to enlighten others. Home dialysis: Barriers, obstacles … or opportunities? Should we look at the 10% of patients on home dialysis and believe this can be better, maybe 20%-30% of the patient population? Some dialysis providers, like Satellite Healthcare and Northwest Kidney Centers, are in that range. Why can't other dialysis providers do the same? There are barriers that need to be addressed. Or perhaps opportunities that need to be explored. (Congressmen urge better home hemodialysis incentives)

An engineer who climbs mountains? An emergency room physician? The agenda for Home Dialyzors United's 3rd Annual Meet Up & Conference next month includes individuals who have figured out how to successfully integrate their kidney failure into their daily lives.

Last month, NN&I published its 18th annual ranking of the largest dialysis providers in the United States. Since 1995—the first year we published our ranking—the chart has always divided hemodialysis patients (including home hemodialysis) and peritoneal dialysis patients as part of the total patient count for each provider. In that first year, we listed 11,954 patients on peritoneal dialysis, representing 15.8% of the total patient population.

The studies have been done; the financial incentives have been improved. What are the next steps to increasing the use of home therapies in the kidney disease population? (CEs available)