Exploring Barriers and Potential Solutions in Home Dialysis: An NKF-KDOQI Conference Outcomes Report
Christopher T Chan1, Eric Wallace2, Thomas A Golper3
1University Health Network, Toronto, Ontario, Canada.
Summary
Home dialysis therapy is underused due to clinical, operational, policy, and societal barriers. Overcoming these requires improved education, patient support, and simplified procedures for chronic kidney failure treatment.
Area of Science:
- Nephrology
- Renal Replacement Therapy
Background:
- Home dialysis, encompassing home hemodialysis and peritoneal dialysis, remains underutilized for chronic kidney failure.
- A 2017 conference identified significant barriers hindering the initiation and continuation of home dialysis therapies.
Purpose of the Study:
- To identify clinical, operational, policy, and societal barriers to home dialysis therapy.
- To explore strategies for increasing patient and provider familiarity and access to home dialysis options.
Main Methods:
- A conference sponsored by the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative convened experts to discuss home dialysis.
- Identification and categorization of barriers through expert discussion and consensus.
Main Results:
- Key barriers include inadequate patient and provider education, lack of exposure, insufficient psychosocial and financial support, and operational challenges.
- Hesitancy in referring patients stems from a lack of familiarity with home dialysis modalities.
Conclusions:
- Facilitating home dialysis requires systematic changes in chronic kidney disease education and dialysis initiation processes.
- Incentives and simplified procedures are crucial for increasing home dialysis adoption.
- Addressing patient and care partner support is vital to prevent dropout and improve treatment modality choice.
Related Concept Videos
01:27Dialysis
1.4K
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
1.4K
01:15Dialysis
1.8K
Dialysis is a diffusion-based purification process that separates analyte molecules from a complex matrix. This is accomplished by allowing molecules in the solution to pass through a semipermeable membrane into a liquid on the other side. The membrane is usually made of cellulose acetate or cellulose nitrate, and the second liquid must be miscible with the solution. Ions (e.g., chloride or sodium) or organic molecules (e.g., glucose) can pass through the membrane pores, which generally have...
1.8K
02:16Solution Formation
37.6K
There is no one solvent that can dissolve every type of solute. Some substances that readily dissolve in a certain solvent might be insoluble in a different solvent. A simple way to predict which substances dissolve in which solvent is the phrase "like dissolves like". This means that polar substances, such as salt and sugar, dissolve in a polar substance like water. In contrast, non-polar substances are more soluble in non-polar solvents such as carbon tetrachloride.
This selective...
This selective...
37.6K
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
754
Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
754
02:24Predicting Reaction Outcomes
10.8K
Kinetics describes the rate and path by which a reaction occurs. In contrast, thermodynamics deals with state functions and describes the properties, behavior, and components of a system. It is not concerned with the path taken by the process and cannot address the rate at which a reaction occurs. Although it does provide information about what can happen during a reaction process, it does not describe the detailed steps of what appears on an atomic or a molecular level. On the other hand,...
10.8K
01:30Peritoneal Dialysis I: Introduction and Procedure
3.0K
Peritoneal dialysis (PD) is a procedure that facilitates the exchange of solutes, waste products, electrolytes, and excess fluid between the blood in the peritoneal capillaries and a dialysis solution introduced into the peritoneal cavity.Principles of Peritoneal Dialysis (PD)Diffusion: Waste products such as urea and electrolytes move from high concentrations in the blood to low concentrations in the dialysate across the peritoneal membrane. This mechanism is driven by the concentration...
3.0K