TY - JOUR
T1 - Home dialysis
T2 - conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference
AU - for Conference Participants
AU - Perl, Jeffrey
AU - Brown, Edwina A.
AU - Chan, Christopher T.
AU - Couchoud, Cécile
AU - Davies, Simon J.
AU - Kazancioğlu, Rümeyza
AU - Klarenbach, Scott
AU - Liew, Adrian
AU - Weiner, Daniel E.
AU - Cheung, Michael
AU - Jadoul, Michel
AU - Winkelmayer, Wolfgang C.
AU - Wilkie, Martin E.
AU - Abrahams, Alferso C.
AU - Anumudu, Samaya J.
AU - Bargman, Joanne M.
AU - Moore, Geraldine Biddle
AU - Blake, Peter G.
AU - Borman, Natalie
AU - Bowes, Elaine
AU - Burton, James O.
AU - Caillette-Beaudoin, Agnes
AU - Cho, Yeoungjee
AU - Cullis, Brett
AU - Einbinder, Yael
AU - el Shamy, Osama
AU - Erickson, Kevin F.
AU - Figueiredo, Ana E.
AU - Finkelstein, Fred
AU - Fluck, Richard
AU - Flythe, Jennifer E.
AU - Fotheringham, James
AU - Fukagawa, Masafumi
AU - Goffin, Eric
AU - Golper, Thomas A.
AU - Gómez, Rafael
AU - Jha, Vivekanand
AU - Johnson, David W.
AU - Kanjanabuch, Talerngsak
AU - Kim, Yong Lim
AU - Lambie, Mark
AU - Lerma, Edgar V.
AU - Lockridge, Robert S.
AU - Loud, Fiona
AU - Masakane, Ikuto
AU - Matthews, Nicola
AU - McKane, Will
AU - Mendelssohn, David C.
AU - Mettang, Thomas
AU - Mitra, Sandip
N1 - Publisher Copyright:
© 2023 International Society of Nephrology
PY - 2023/5
Y1 - 2023/5
N2 - Home dialysis modalities (home hemodialysis [HD] and peritoneal dialysis [PD]) are associated with greater patient autonomy and treatment satisfaction compared with in-center modalities, yet the level of home-dialysis use worldwide is low. Reasons for limited utilization are context-dependent, informed by local resources, dialysis costs, access to healthcare, health system policies, provider bias or preferences, cultural beliefs, individual lifestyle concerns, potential care-partner time, and financial burdens. In May 2021, KDIGO (Kidney Disease: Improving Global Outcomes) convened a controversies conference on home dialysis, focusing on how modality choice and distribution are determined and strategies to expand home-dialysis use. Participants recognized that expanding use of home dialysis within a given health system requires alignment of policy, fiscal resources, organizational structure, provider incentives, and accountability. Clinical outcomes across all dialysis modalities are largely similar, but for specific clinical measures, one modality may have advantages over another. Therefore, choice among available modalities is preference-sensitive, with consideration of quality of life, life goals, clinical characteristics, family or care-partner support, and living environment. Ideally, individuals, their care-partners, and their healthcare teams will employ shared decision-making in assessing initial and subsequent kidney failure treatment options. To meet this goal, iterative, high-quality education and support for healthcare professionals, patients, and care-partners are priorities. Everyone who faces dialysis should have access to home therapy. Facilitating universal access to home dialysis and expanding utilization requires alignment of policy considerations and resources at the dialysis-center level, with clear leadership from informed and motivated clinical teams.
AB - Home dialysis modalities (home hemodialysis [HD] and peritoneal dialysis [PD]) are associated with greater patient autonomy and treatment satisfaction compared with in-center modalities, yet the level of home-dialysis use worldwide is low. Reasons for limited utilization are context-dependent, informed by local resources, dialysis costs, access to healthcare, health system policies, provider bias or preferences, cultural beliefs, individual lifestyle concerns, potential care-partner time, and financial burdens. In May 2021, KDIGO (Kidney Disease: Improving Global Outcomes) convened a controversies conference on home dialysis, focusing on how modality choice and distribution are determined and strategies to expand home-dialysis use. Participants recognized that expanding use of home dialysis within a given health system requires alignment of policy, fiscal resources, organizational structure, provider incentives, and accountability. Clinical outcomes across all dialysis modalities are largely similar, but for specific clinical measures, one modality may have advantages over another. Therefore, choice among available modalities is preference-sensitive, with consideration of quality of life, life goals, clinical characteristics, family or care-partner support, and living environment. Ideally, individuals, their care-partners, and their healthcare teams will employ shared decision-making in assessing initial and subsequent kidney failure treatment options. To meet this goal, iterative, high-quality education and support for healthcare professionals, patients, and care-partners are priorities. Everyone who faces dialysis should have access to home therapy. Facilitating universal access to home dialysis and expanding utilization requires alignment of policy considerations and resources at the dialysis-center level, with clear leadership from informed and motivated clinical teams.
KW - dialysis modality
KW - healthcare policy
KW - hemodialysis
KW - home dialysis
KW - peritoneal dialysis
KW - quality of life
UR - http://www.scopus.com/inward/record.url?scp=85149681722&partnerID=8YFLogxK
U2 - 10.1016/j.kint.2023.01.006
DO - 10.1016/j.kint.2023.01.006
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C2 - 36731611
AN - SCOPUS:85149681722
SN - 0085-2538
VL - 103
SP - 842
EP - 858
JO - Kidney International
JF - Kidney International
IS - 5
ER -
