Nav: Home

Survival following switch from urgent in-center hemodialysis to home dialysis

November 07, 2019

Washington, DC (November 7, 2019) -- Researchers have studied whether patients who start urgent and unplanned dialysis in clinics experience a survival benefit when they switch to home dialysis. The results will be presented at ASN Kidney Week 2019 November 5-November 10 at the Walter E. Washington Convention Center in Washington, DC.

Most patients who start urgent and unplanned dialysis receive hemodialysis in clinical centers but might prefer and benefit from home dialysis, which includes peritoneal dialysis (PD) and home hemodialysis (HDD). Sonny Nguyen, MD (Harbor-UCLA Medical Center) and his colleagues examined information on patients who transitioned from in-center hemodialysis to home dialysis early following an unplanned start of dialysis, and they determined whether those who transitioned early had a lower risk of death.

Of 190,642 patients identified in the United States Renal Data System who initiated urgent in-center hemodialysis from 2005 to 2013, 3923 (2%) transitioned to PD and 853 (0.4%) to HHD, with an average time on PD and HHD of 413 and 224 days, respectively. Younger age, white race, private insurance, and initiating dialysis in a unit that has a PD program were associated with higher likelihood of an early PD transition. In contrast, older age, living in the Midwest or South and in wealthier neighborhoods, and initiating dialysis in a unit that has a HHD program was associated with making an early HHD transition.

Those who had transitioned to PD were just as likely to die during the study period as those who had never transitioned to home dialysis; however, those who had transitioned to HHD had a 17% higher risk of death compared with those who had never transitioned to home dialysis.

"Few patients who start in-center hemodialysis urgently and unplanned make an early transition to home dialysis. Starting dialysis in a center that also has a home dialysis program may help facilitate these transitions by increased exposure, awareness, and education about home dialysis," said Dr. Nguyen. "The different risk factors and demographics of patients transitioning to peritoneal dialysis and home hemodialysis early suggest that these therapies may attract different types of patients and may explain the differences in outcomes between peritoneal dialysis and home hemodialysis that we observed; however, further research is needed to understand the higher mortality among early transitions to home hemodialysis."
-end-
Study: "Early Transitions from In-Center HD to Home Dialysis"

ASN Kidney Week 2019, the largest nephrology meeting of its kind, will provide a forum for more than 13,000 professionals to discuss the latest findings in kidney health research and engage in educational sessions related to advances in the care of patients with kidney and related disorders. Kidney Week 2019 will take place November 5 - November 10 in Washington, DC.

Since 1966, ASN has been leading the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients. ASN has more than 20,000 members representing 131 countries. For more information, please visit http://www.asn-online.org or contact the society at 202-640-4660.

American Society of Nephrology

Related Dialysis Articles:

Is ownership of dialysis facilities associated with access to kidney transplants?
An analysis that included data for nearly 1.5 million patients with end-stage kidney disease looked at whether ownership of dialysis facilities was associated with patients' access to kidney transplants.
At-home dialysis improves quality of life
The rate of people starting voluntary at-home peritoneal dialysis rose from 15% to 34% over 10 years at Kaiser Permanente in Northern California, providing a convenient and safe way to manage advanced-stage kidney disease compared with center-based hemodialysis, according to research published today in JAMA Internal Medicine.
Hydration sensor could improve dialysis
Researchers from MIT and Massachusetts General Hospital have now developed a portable sensor that can accurately measure patients' hydration levels using a technique known as nuclear magnetic resonance (NMR) relaxometry.
Uncovering possible role of polyphosphate in dialysis-related amyloidosis
Researchers from Osaka University found that the low concentrations of the naturally occurring biopolymer, polyphosphate (polyP), induces amyloid formation from β2 microglobulin under both acidic and neutral conditions but by different mechanisms.
Study compares scheduled vs. emergency-only dialysis among undocumented immigrants
A unique opportunity made it feasible for uninsured patients with end-stage renal disease (ESRD) who received emergency-only dialysis in Dallas, Texas, to enroll in private, commercial health insurance plans in 2015 and that made it possible for researchers to compare scheduled vs. emergency-only dialysis among undocumented immigrants with ESRD.
Study compares dialysis reimbursement around the globe
Dialysis reimbursement policies in most countries are focused on conventional in-center hemodialysis, although home hemodialysis and peritoneal dialysis might contribute to quality of life and cost savings.
Elderly patients on dialysis have a high risk of dementia
Older kidney disease patients who are sick enough to require the blood-filtering treatment known as dialysis are at high risk of dementia, including Alzheimer's disease, according to a study led by scientists at Johns Hopkins Bloomberg School of Public Health.
Only 10 percent of non-dialysis kidney patients ever see a dietitian
In patients with chronic kidney disease, medical nutrition therapy can slow the progression and significantly reduce healthcare costs.
Undocumented immigrants have higher risk of death with emergency-only dialysis
Undocumented immigrants with end-stage kidney disease were much more likely to die and to spend more time in the hospital when they could access dialysis only as an emergency once they became critically ill.
UC researchers examine racial and gender disparities in dialysis patients
UC researchers are examining racial and gender disparities in dialysis patients as well as the impact of poor functional status and pre-dialysis hospitalizations on elderly dialysis patients.
More Dialysis News and Dialysis Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

Risk
Why do we revere risk-takers, even when their actions terrify us? Why are some better at taking risks than others? This hour, TED speakers explore the alluring, dangerous, and calculated sides of risk. Guests include professional rock climber Alex Honnold, economist Mariana Mazzucato, psychology researcher Kashfia Rahman, structural engineer and bridge designer Ian Firth, and risk intelligence expert Dylan Evans.
Now Playing: Science for the People

#540 Specialize? Or Generalize?
Ever been called a "jack of all trades, master of none"? The world loves to elevate specialists, people who drill deep into a single topic. Those people are great. But there's a place for generalists too, argues David Epstein. Jacks of all trades are often more successful than specialists. And he's got science to back it up. We talk with Epstein about his latest book, "Range: Why Generalists Triumph in a Specialized World".
Now Playing: Radiolab

Dolly Parton's America: Neon Moss
Today on Radiolab, we're bringing you the fourth episode of Jad's special series, Dolly Parton's America. In this episode, Jad goes back up the mountain to visit Dolly's actual Tennessee mountain home, where she tells stories about her first trips out of the holler. Back on the mountaintop, standing under the rain by the Little Pigeon River, the trip triggers memories of Jad's first visit to his father's childhood home, and opens the gateway to dizzying stories of music and migration. Support Radiolab today at Radiolab.org/donate.