Exploring Barriers and Potential Solutions in Home Dialysis: An NKF-KDOQI Conference Outcomes Report

Chan, Christopher T.; Wallace, Eric; Golper, Thomas A.; Rosner, Mitchell H.; Seshasai, Rebecca Kurnik; Glickman, Joel D.; Schreiber, Martin J.; Gee, Patrick; Rocco, Michael V.

doi:10.1053/j.ajkd.2018.09.015

Cited by 79 publications

(95 citation statements)

References 49 publications

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“…Background and Importance Low patient awareness and education regarding home dialysis has been identified as a major barrier to increasing US home dialysis patients. 5 In 2016,~35% of dialysis patients began dialysis with little to no nephrology care 3 and most began treatment in the hospital. There are many barriers to starting patients on a home therapy if they need to start dialysis emergently in the hospital.…”

Section: Awareness and Educationmentioning

confidence: 99%

“…Background and Importance Home dialysis is an underused form of KRT. 5 Barriers against adopting home dialysis include the reluctance of Box 1. Home Dialysis Awareness and Education Actionable Steps…”

Section: Education and Mentorship For Home Dialysis Providersmentioning

confidence: 99%

“…8 Therefore, the NKF convened a special task force to better understand potential strategies to overcome challenges to enhance home dialysis adoption. 5 Action Items and How to Execute Enhancing mentorship and education for all home dialysis care providers was an overarching theme during our meeting. Evidence has shown that the size of a home dialysis unit correlates directly with outcomes, whereby larger units have improved outcomes compared with smaller units.…”

Section: Action Itemsmentioning

confidence: 99%

“…We propose conducting pilot programs in both care partner mentoring and assessment of care partner burnout (Boxes 4 and 5). 5 Peer Mentoring…”

Section: Care Partner Supportmentioning

confidence: 99%

“…The 2018 NKF-KDOQI Home Dialysis Conference built on the goals of the first such conference held a year earlier, which focused on identifying barriers to home dialysis in terms of initiating home therapies and in retention of home dialysis patients. 5 The focus of the second conference was to develop practical action points that would benefit not only home dialysis programs but also patients and their care partners. The programs and recommendations for research discussed in this report are based on the discussions at the meeting with stakeholders in home dialysis, including patients, care partners, physicians, nurses, advanced practitioners, social workers, dietitians, technicians, and representatives from dialysis organizations and the CMS.…”

mentioning

confidence: 99%

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Overcoming Barriers for Uptake and Continued Use of Home Dialysis: An NKF-KDOQI Conference Report

Chan

Collins

Ditschman³

et al. 2020

American Journal of Kidney Diseases

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Section: Awareness and Educationmentioning

confidence: 99%

Section: Education and Mentorship For Home Dialysis Providersmentioning

confidence: 99%

Section: Action Itemsmentioning

confidence: 99%

“…We propose conducting pilot programs in both care partner mentoring and assessment of care partner burnout (Boxes 4 and 5). 5 Peer Mentoring…”

Section: Care Partner Supportmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Overcoming Barriers for Uptake and Continued Use of Home Dialysis: An NKF-KDOQI Conference Report

Chan

Collins

Ditschman³

et al. 2020

American Journal of Kidney Diseases

Self Cite

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Barriers and Facilitators to Home Dialysis Among Latinx Patients with Kidney Disease

et al. 2023

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ImportanceLatinx people have a high burden of kidney disease but are less likely to receive home dialysis compared to non-Latinx White people. The disparity in home dialysis therapy has not been completely explained by demographic, medical, or social factors.ObjectiveTo understand the barriers and facilitators to home dialysis therapy experienced by Latinx individuals with kidney failure receiving home dialysis.Design, Setting, and ParticipantsThis qualitative study used semistructured interviews with Latinx adults with kidney failure receiving home dialysis therapy in Denver, Colorado, and Houston, Texas, between November 2021 and March 2023. Patients were recruited from home dialysis clinics affiliated with academic medical centers. Of 39 individuals approached, 27 were included in the study. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis.Main Outcomes and MeasuresThemes and subthemes regarding barriers and facilitators to home dialysis therapy.ResultsA total of 27 Latinx adults (17 [63%] female and 10 [37%] male) with kidney failure who were receiving home dialysis participated. Themes and subthemes were identified, 3 related to challenges with home dialysis and 2 related to facilitators. Challenges to home dialysis included misinformation and immigration-related barriers to care (including cultural stigma of dialysis, misinformation regarding chronic disease care, and lack of health insurance due to immigration status), limited dialysis education (including lack of predialysis care, no-nephrologist education, and shared decision-making), and maintenance of home dialysis (including equipment issues, lifestyle restrictions, and anxiety about complications). Facilitators to home dialysis included improved lifestyle (including convenience, autonomy, physical symptoms, and dietary flexibility) and support (including family involvement, relationships with staff, self-efficacy, and language concordance).Conclusions and RelevanceLatinx participants in this study who were receiving home dialysis received misinformation and limited education regarding home dialysis, yet were engaged in self-advocacy and reported strong family and clinic support. These findings may inform new strategies aimed at improving access to home dialysis education and uptake for Latinx individuals with kidney disease.

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Peritoneal Dialysis Patient Selection

Njue

Yaqoob²,

Nobakht³

2021

Applied Peritoneal Dialysis

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Exploring Barriers and Potential Solutions in Home Dialysis: An NKF-KDOQI Conference Outcomes Report

Cited by 79 publications

References 49 publications

Overcoming Barriers for Uptake and Continued Use of Home Dialysis: An NKF-KDOQI Conference Report

Overcoming Barriers for Uptake and Continued Use of Home Dialysis: An NKF-KDOQI Conference Report

Barriers and Facilitators to Home Dialysis Among Latinx Patients with Kidney Disease

Peritoneal Dialysis Patient Selection

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