New York, NY –Dec. 5, 2018 – A team of kidney professionals, patients and caregivers met in Baltimore Nov. 30 to work through ways to remove barriers to home dialysis so more patients will treat kidney failure at home rather than in a center.
The first KDOQI Home Dialysis Conference was held a year ago. On Nov. 30, a group of more than 70 invited clinicians, researchers, policy makers, patients, care partners, and industry representatives gathered to launch the “Home Dialysis Quality Initiative,” a major, multi-disciplinary effort. The National Kidney Foundation produces clinical practice guidelines through the NKF Kidney Disease Outcomes Quality Initiative (NKF KDOQI)™. This program has provided evidence-based guidelines for all stages of chronic kidney disease (CKD) and related complications since 1997.
“There was palpable energy in the room that those present are ready to spread throughout the nephrology community so that we can achieve a ‘home-first’ philosophy,” said patient advocate and conference co-chair Erich Ditschman, a kidney patient himself.
Research suggests that patients who treat their kidney failure at home live happier, healthier lives than those who must follow the rigid schedule of dialysis centers. Patients who perform dialysis in their homes have lower rates of depression, unemployment and have more overall flexibility.
“I was delighted to see the enthusiasm of all of the participants to make home dialysis the first therapy for patients with end-stage kidney disease,” said Michael Rocco, MD, MSCE, conference co-chair, nephrologist, and Professor of Medicine at Wake Forest University in Winston-Salem, NC.
Over the last year, three working groups designed projects that could overcome barriers to getting, or keeping, patients on home dialysis, including overcoming lack of training and support for care partners. Based on the presentations and the feedback at the conference, a new KDOQI initiative will be designed to raise awareness about home dialysis, find ways to encourage home dialysis as a first choice for treatment for kidney failure and prevent home dialysis patients from quitting treating at home because they are burned out. The teams found that creating opportunities for mentorships among patients and caregivers and education of all kidney professionals and patients are key to successful home dialysis.
“KDOQI has been improving care and outcomes for all stages of kidney disease for over 20 years, by educating patients and professionals, providing peer mentors and working with CMS to help align payments with the best clinical practices,” said Kerry Willis, PhD, Chief Scientific Officer of NKF. “We look forward to applying this model to home dialysis.”
Amy Bassano, Deputy Director for the Center for Medicare & Medicaid Innovation (CMMI), presented a keynote, which provided a roadmap for how CMMI develops new care models and payment. She discussed how CMMI has already been developing a care model for home dialysis.
“CMS and HHS leadership are committed to realigning payment incentives to ensure kidney patients receive the highest quality care in the most appropriate setting and that includes increasing the utilization of home dialysis,” Bassano said.
This conference was partially funded through a Patient-Centered Outcomes Research Institute (PCORI) Engagement Award Initiative (EAIN-6117).
How is CKD Treated?
The best treatment is early detection when chronic kidney disease can be slowed or stopped. Early treatment includes diet, exercise, and medications. However, once kidneys fail, treatment with dialysis or a kidney transplant is needed.
Dialysis comes in two forms: hemodialysis or peritoneal dialysis. Hemodialysis is a treatment (usually 3–4 times a week) that removes wastes and extra fluid from your blood. It can be done at home or at a dialysis center. During hemodialysis, your blood is pumped through a dialysis machine, where it is cleaned and returned to your body. With peritoneal dialysis, your blood is cleaned inside your body through the lining of your abdomen using a special fluid that is periodically changed. Peritoneal dialysis can be done at home, at work, at school, or even during travel.
A kidney transplant places a healthy kidney into your body from a deceased donor or from a living donor, such as a close relative, spouse, friend, or generous stranger. A kidney transplant, however, is a treatment, not a cure. Antirejection and other medications are needed to maintain the transplant.
Over 475,000 ESRD patients receive dialysis at least 3 times per week to replace kidney function. 121,000 people started ESRD treatment in 2014, of which 118,000 started dialysis. Over 200,000 Americans live with a kidney transplant. 100,000 Americans are waiting on a kidney transplant right now. But only about 19,000 will receive one this year, one-third of which will come from living donors.
NKF Professional Membership
Healthcare professionals can join NKF to receive access to tools and resources for both patients and professionals, subscriptions to professional journals, discounts on professional education, opportunities to apply for research grants, and access to a network of thousands of individuals who treat patients with kidney disease.
Kidney Disease Facts
In the United States 30 million adults are estimated to have chronic kidney disease—and most aren’t aware of it. 1 in 3 American adults are at risk for chronic kidney disease. Risk factors for kidney disease include diabetes, high blood pressure, heart disease, obesity and family history. People of African American, Hispanic, Native American, Asian or Pacific Islander descent are at increased risk for developing the disease. African Americans are 3 times more likely than Whites, and Hispanics are nearly 1.5 times more likely than non-Hispanics to develop end stage renal disease (kidney failure).
The National Kidney Foundation (NKF) is the largest, most comprehensive and longstanding organization dedicated to the awareness, prevention and treatment of kidney disease. For more information about the NKF visit www.kidney.org.