- Study looks at how the COVID-19 pandemic impacted shared decision-making between clinicians, older patients with chronic kidney disease, and their care partners
- While clinicians supported more home-based treatment plans during the COVID-19 pandemic, discussions with patients and their caregivers recommending these options were limited
COVID-19 interfered with regular medical care for many people, including older patients with advanced chronic kidney disease (CKD). A recent study published in the Clinical Journal of the American Society of Nephrology (CJASN) examined how shared decision-making—the process by which clinicians, patients, and their care partners work together to make decisions about treatments and care—was impacted by COVID-19.
In this study, researchers interviewed 76 adults (39 older patients with advanced CKD, 17 care partners, and 20 clinicians) from Boston, Portland (Maine), San Diego, and Chicago from August 2020 to December 2020. The researchers found that clinicians supported more home-based treatment plans during the COVID-19 pandemic, but actual conversations with patients and their caregivers encouraging these options were limited. Some patients reported feeling like they needed to figure out how to cope with COVID-19 and their kidney treatment options on their own.
While the early days of the COVID-19 pandemic were certainly filled with concern for many, we now have learnings that can be used moving forward. The authors of the study have stated that improvements can be made. For example, in shared decision-making during a pandemic and afterward, clinicians should consider promoting and encouraging conversations with patients who want to talk about COVID-19, with an emphasis on safety and quality of life, including the risks posed to them by COVID-19 and the impact of COVID-19 on kidney treatment options.
Some CKD treatments require outside care, for example, kidney transplants, but did you know that there are other life-saving treatments that can be done at home, such as home dialysis? In fact, in uncertain times, like a pandemic, home dialysis may, in fact, be a safer, more convenient, and less stressful option. There are a few different types to consider and discuss with your kidney doctor:
- Conventional home hemodialysis: You do this three times a week for three to four hours or longer each time. You and your care partner are trained to do dialysis safely and to handle any problems that may come up.
- Short daily home hemodialysis: This is usually done five to seven times a week using dialysis machines designed for short daily home treatments, which usually last about two hours each. Because you are doing dialysis more often, less fluid generally needs to be removed each time. This reduces symptoms like headaches, nausea, cramping, and feeling “washed out” after treatment.
- Nocturnal home hemodialysis: Long, slow treatments done at night while you sleep. You may do this kind of dialysis six nights a week or every other night. This depends on what your doctor prescribes for you. Treatments usually last about six to eight hours.
If you would like more information about home dialysis, please contact us.