Home dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Perl, Jeffrey; Brown, Edwina A.; Chan, Christopher T.; Couchoud, Cécile; Davies, Simon; Kazancıoğlu, Rümeyza; Klarenbach, Scott; Liew, Adrian; Weiner, Daniel E.; Cheung, Michael; Jadoul, Michel; Winkelmayer, Wolfgang C.; Wilkie, Martin; Abrahams, Alferso C; Anumudu, Samaya; Bargman, Joanne M.; Moore, Geraldine Biddle; Blake, Peter G.; Borman, Natalie; Bowes, Elaine; Burton, James O.; Caillette-Beaudoin, A.; Cho, Yeoungjee; Cullis, Brett; Einbinder, Yael; Shamy, Osama El; Erickson, Kevin F.; Figueiredo, Ana Elizabeth; Finkelstein, Fred; Fluck, Richard; Flythe, Jennifer E.; Fotheringham, James; Fukagawa, Masafumi; Goffin, Éric; Golper, Thomas A.; Gómez, Rafael; Jha, Vivekanand; Johnson, David W.; Kanjanabuch, Talerngsak; Kim, Yong-Lim; Lambie, Mark; Lerma, Edgar V.; Lockridge, Robert S.; Loud, Fiona; Masakane, Ikuto; Matthews, Nicola; McKane, W S.; Mendelssohn, David C.; Mettang, Thomas; Mitra, Sandip; Morton, Rachael L.; Mushahar, Lily; Nadeau‐Fredette, Annie‐Claire; Nayak, K.S.; Neumann, Joanna Lee; Ngaruiya, Grace; Okpechi, Ikechi G.; Quinn, Robert R.; Rangaswami, Janani; Reddy, Yuvaram N.V.; Schiller, Brigitte; Shen, Jenny I.; Shroff, Rukshana; Roblero, María Fernanda Slon; Solá, Laura; Søndergaard, Henning; Teitelbaum, Isaac; Tennankore, Karthik; Ommeslaeghe, Floris Van; Walker, Rachael; Walker, Robert; Wang, Angela Yee-Moon; Warady, Bradley A.; Watnick, Suzanne; Weinhandl, Eric D.; Wilkie, Caroline; Williams, Jennifer

doi:10.1016/j.kint.2023.01.006

Cited by 43 publications

(31 citation statements)

References 128 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Strong consideration should be given to frequent dialysis sessions to reduce left ventricular hypertrophy/left ventricular mass index and HF hospitalizations and to improve quality of life. [133][134][135] When medication classes such as β-adrenergic receptor blockers or ACE inhibitors are used, the dialyzability of these agents and their timing with the dialysis cycle should be factored into the treatment plan. 136 Ongoing trials are looking at potential cardiovascular benefits with the use of steroidal mineralocorticoid receptor antagonists (NCT01848639, NCT03020303) and SGLT2 inhibitors (NCT05685394, NCT05179668, NCT05374291) in patients on dialysis.…”

Section: Stage 4b Ckm: Kidney Failurementioning

confidence: 99%

Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association

Ndumele,

Rangaswami,

Chow

et al. 2023

Circulation

Self Cite

134

View full text Add to dashboard Cite

Cardiovascular-kidney-metabolic health reflects the interplay among metabolic risk factors, chronic kidney disease, and the cardiovascular system and has profound impacts on morbidity and mortality. There are multisystem consequences of poor cardiovascular-kidney-metabolic health, with the most significant clinical impact being the high associated incidence of cardiovascular disease events and cardiovascular mortality. There is a high prevalence of poor cardiovascular-kidney-metabolic health in the population, with a disproportionate burden seen among those with adverse social determinants of health. However, there is also a growing number of therapeutic options that favorably affect metabolic risk factors, kidney function, or both that also have cardioprotective effects. To improve cardiovascular-kidney-metabolic health and related outcomes in the population, there is a critical need for (1) more clarity on the definition of cardiovascular-kidney-metabolic syndrome; (2) an approach to cardiovascular-kidney-metabolic staging that promotes prevention across the life course; (3) prediction algorithms that include the exposures and outcomes most relevant to cardiovascular-kidney-metabolic health; and (4) strategies for the prevention and management of cardiovascular disease in relation to cardiovascular-kidney-metabolic health that reflect harmonization across major subspecialty guidelines and emerging scientific evidence. It is also critical to incorporate considerations of social determinants of health into care models for cardiovascular-kidney-metabolic syndrome and to reduce care fragmentation by facilitating approaches for patient-centered interdisciplinary care. This presidential advisory provides guidance on the definition, staging, prediction paradigms, and holistic approaches to care for patients with cardiovascular-kidney-metabolic syndrome and details a multicomponent vision for effectively and equitably enhancing cardiovascular-kidney-metabolic health in the population.

show abstract

Section: Stage 4b Ckm: Kidney Failurementioning

confidence: 99%

Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association

Ndumele,

Rangaswami,

Chow

et al. 2023

Circulation

Self Cite

134

View full text Add to dashboard Cite

show abstract

“…1). Den Patienten in Deutschland und den europäischen Ländern sollte der Zugang zu allen Dialysemodalitäten ermöglicht werden [5,34,36].…”

Section: Deutschlandunclassified

Assistierte Dialyse: Was entwickelt sich in Deutschland und darüber hinaus?

Kitsche

Iseke

Oleimeulen

2023

Nephrologie aktuell

View full text Add to dashboard Cite

ZUSAMMENFASSUNGDie Anwendung der Heimdialyseverfahren ist in Deutschland nach wie vor gering 1–3. Das trifft insbesondere auf die assistierte Heimdialyse zu. Dabei könnte vor dem demografischen Hintergrund, wenn in den kommenden Jahren die Babyboomer in den Ruhestand gehen, die assistierte Peritonealdialyse (asPD) eine gute Therapieoption für die steigende Zahl der dialysepflichtigen älteren Patienten sein. Dieser Artikel beschreibt die aktuelle Versorgungssituation in Deutschland und weist auf Aktivitäten hier und in den Nachbarländern hin.

show abstract

“…Kidney Disease Improving Global Outcomes recommends an iterative approach in modality education because it has been shown to lead to greater home dialysis utilization. 10,11 A large dialysis organization in the United States demonstrated an adjusted odds ratio of 5.13 (95% confidence interval, 3.58 to 7.35) for choosing PD over in-center HD and a 90-day mortality odds ratio of 0.61 (95% confidence interval, 0.50 to 0.74) with education. 12 Similarly, a matched control study demonstrated that CKD education led a three-fold increase with respect to home dialysis uptake (38.5% versus 12.6%, P , 0.001).…”

Section: Patient Educationmentioning

confidence: 99%

Systems Innovations to Increase Home Dialysis Utilization

Cheng,

Chan

2023

CJASN

Self Cite

View full text Add to dashboard Cite

Globally, there is an interest to increase home dialysis utilization. The most recent USRDS data reports that 13.3% of incident dialysis patients in the US are started on home dialysis, while the majority of patients continue to initiate kidney replacement therapy with in-center hemodialysis. In order to affect meaningful change, a multi-faceted innovative approach will be needed to substantially increase the use of home dialysis. Patient and provider education is the first step to enhance home dialysis knowledge awareness. Ideally, one should maximize the number of chronic kidney disease stage V patients transitioning to home therapies. If this is not possible, infrastructures including transitional dialysis units and community dialysis houses may help patients increase self-care efficacy and eventually transition care to home. From a policy perspective, adopting a “home dialysis preference” mandate and providing financial support to recuperate increased costs for patients and providers have led to higher uptake in home dialysis. Lastly, respite care and planned home-to-home transitions can reduce the incidence of transitioning to in-center hemodialysis. We speculate that an ecosystem of complementary system innovations is needed to cause a sufficient change in patient and provider behavior, which will ultimately modify the overall home dialysis utilization.

show abstract

Home dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Cited by 43 publications

References 128 publications

Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association

Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association

Assistierte Dialyse: Was entwickelt sich in Deutschland und darüber hinaus?

Systems Innovations to Increase Home Dialysis Utilization

Contact Info

Product

Resources

About