There has been a recent shift in kidney care with both industry leaders and the White House showing support of home dialysis. This forward momentum is due to several advantages home dialysis offers patients, such as lower mortality rates,1 flexible treatment schedules,2 and reduced cost.3 Merit Medical is pleased to support this transition by providing dialysis patient education, clinician training, and a number of therapeutic products.

Heading the movement are international industry leaders DaVita® Kidney Care and Fresenius Kidney Care with an initiative called 20% by 2020, a program that aims to have 20% of dialysis patients on home dialysis therapy by the year 2020. Both DaVita and Fresenius provide two types of home dialysis options: peritoneal dialysis (PD) and hemodialysis.

“The initiative is important from several standpoints,” says John H. Crabtree, MD, general surgeon, chair of PD University for Surgeons-North America, and visiting clinical faculty at Harbor-UCLA Medical Center in Torrance, CA. “Number one, patients do better on home dialysis.”

Patients on PD therapy in particular, a group that comprises the majority of the home dialysis-treatment population, “have improved survival over the early years on treatment,” Dr. Crabtree told Merit Medical.4 Moreover, for individuals who receive a kidney transplant, “the results tend to be better when they were on peritoneal dialysis prior to the surgery as opposed to hemodialysis.”5

Home dialysis also offers greater autonomy. Because patients are properly trained and therapy can be done overnight, home dialysis allows for a regular work schedule.3 Moreover, the average cost of care for home dialysis is less.3 PD in particular, Dr. Crabtree went on to explain, is approximately $15,000 less per patient per year compared to hemodialysis.6

The White House recently announced a new government-sponsored payment approach for treating kidney disease that favors lower cost home dialysis. The U.S. Centers for Medicare and Medicaid Services is considering a trial program design that would improve care in the early stages of kidney disease, increase access to kidney transplants, and favor home dialysis over clinic-based treatment.3 It is particularly looking at the benefits of PD.3

Despite these advantages and the fact that many physicians believe 25%–35% of patients would do better on home dialysis therapy, the number of people receiving home dialysis in the US still remains low, with only 7% receiving PD and less than 1% choosing home hemodialysis.7 The 20% by 2020 initiative plans to change this through several avenues.

“The way that we can drive this is by improving patient education…Many patients aren’t provided information about home dialysis,” Dr. Crabtree explains. In addition to patient education, Dr. Crabtree says many physician education programs lack the training needed to take care of PD patients. “[I]t’s important to provide courses [and] educational opportunities that allow them to have hands-on training.”

Merit Medical is ready to address these needs through its Ask4PD™ patient education site and ThinkDialysisAccess™ hands-on physician training experiences. Merit also offers high-quality dialysis products, such as the Flex-Neck® Peritoneal Dialysis Catheter, a premium catheter that allows for up to 30% higher flow rates than other catheters currently on the US market.8

The support for home dialysis is expanding. By providing the tools and education needed to advance the 20% by 2020 initiative, Merit shows its ongoing evolution as a healthcare company as well as its vision to continually find ways to improve patient care.

Watch Dr. Crabtree’s interview to learn more about the benefits of home dialysis and how Merit supports it.

Dr. Crabtree is a paid consultant of Merit Medical.

REFERENCES

  1. DaVita® Kidney Care. (n.d.). Top 5 benefits of home dialysis treatment. Retrieved from https://www.davita.com/treatment-services/home-dialysis/home-benefits/top-5-benefits-of-home-dialysis-treatment.
  2. Fresenius Kidney Care. (2019). Learn more about home dialysis treatment options. Retrieved from https://www.freseniuskidneycare.com/ckd-treatment/benefits-of-home-dialysis.
  3. Copley, C., & Humer, C. (2019, March 3). U.S. seeks to cut dialysis costs with more home care versus clinics. Retrieved from https://www.reuters.com/article/us-usa-healthcare-dialysis/us-seeks-to-cut-dialysis-costs-with-more-home-care-versus-clinics-idUSKCN1QL0G6.
  4. Teixeira, J.P., Combs, S. A., & Teitelbaum, I. (2015). Peritoneal dialysis: Update on patient survival. Clin Nephrol, Jan;83(1):1-10.
  5. Joachim, E., Gardezi, A. I., Chan, M. R., et al. (2017). Association of pre-transplant dialysis modality and post-transplant outcomes: A meta-analysis. Perit Dial Int, May-Jun;37(3):259-265.
  6. United States Renal Data System. (2018). 2018 annual data report (Chapter 9: Healthcare expenditures for persons with ESRD). Retrieved from https://www.usrds.org/2018/view/v2_09.aspx
  7. DaVita Kidney Care. (n.d.). Majority of nephrology professionals prefer home dialysis. Retrieved from https://www.davita.com/treatment-services/home-dialysis/recommended-approach.
  8. Data on file.