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Increasing the adoption of home dialysis through improved advanced kidney care patient education: a call for action
Ulrika Hahn Lundström1, Gert Meeus2, Tommy Aronsen3
1Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Background:
Home dialysis modalities have several advantages yet remain underused in Europe. A minority of people with kidney failure opt for home dialysis, although many more could be suitable. To improve home dialysis uptake, advanced kidney care patient education is essential. The aim was to examine the association of national guidelines for advanced kidney care patient education with home dialysis prevalence and incidence across Europe.
Methods:
This call for action followed a consensus meeting in Copenhagen, Denmark, in June 2023. The participating professionals had extensive experience in advanced kidney care and home dialysis. We used data from the European Renal Association registry 2021 to examine the association of available national guidelines for advanced kidney care education with home dialysis prevalence and incidence in Europe.
Results:
In the European dialysis population, home dialysis prevalence is 10.5% and incidence is 13.3%. The organization of advanced kidney care and patient education differ. The availability of national guidelines for advanced kidney care patient education is associated with home dialysis uptake. The prevalence of home dialysis is significantly higher in countries with versus without national guidelines [20.9 versus 7.9%; odds ratio 1.398 (confidence interval 1.115-1.754), P = .004].
Conclusion:
Home dialysis prevalence and incidence vary in Europe. The availability of national guidelines for advanced kidney care patient education for professionals is associated with a higher prevalence and incidence of home dialysis. Coordinated action is needed to support advanced kidney care patient education as part of nephrology care to improve kidney care, in order to ensure that the right patient is on the right modality and increase access to home dialysis.
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