[Brussels, Belgium] Kidney Disease: Improving Global Outcomes (KDIGO) is pleased to announce the publication of the Home Dialysis Controversies Conference Report
in Kidney International. This virtual Controversies Conference, the third in the KDIGO dialysis series, was co-chaired by Jeffrey Perl, MD (St. Michael’s Hospital, Unity Health, University of Toronto, Canada), and Martin Wilkie, MD (Sheffield Teaching Hospitals NHS Foundation Trust, United Kingdom) in May 2021.
Home dialysis modalities (home hemodialysis [HD] and peritoneal dialysis [PD]) are associated with greater patient autonomy and treatment satisfaction and in many cases improved clinical outcomes and quality of life. “Everyone who faces dialysis should have access to home therapy,” said Dr. Perl. “Unfortunately, in many parts of the world, uptake is low, and access is influenced by a range of factors. There is a pressing need to develop and implement low-cost self-management dialysis and methods for evaluating its effectiveness. Ensuring equitable access to home therapies regardless of sociodemographic and socioeconomic status will require alignment of health policy considerations and resources. While the barriers are significant, we can improve global access to home dialysis with clear leadership from informed and motivated clinical teams.”
To address the relative underutilization of home dialysis therapies, globally, the conference aimed to identify approaches and strategies that expand the use of home dialysis, with consideration toward escalating related costs. Participants conducted an in-depth review of specific and local factors that positively and negatively impact home dialysis use, while considering criteria for candidacy, eligibility, and financial implications for both individuals and care partners. The conference also addressed the impact of increasing home dialysis access on clinical and patient-reported outcomes and how best to improve the home dialysis experience for individuals and care partners.
“Most dialysis patients receive treatment at centers where it is not standard procedure to train people to manage their dialysis at home,” said Dr. Wilkie. “There is now substantial evidence that people with long-term conditions who are more involved in their own care have better outcomes. More effective systems for informing and involving dialysis patients in their treatment will help drive change worldwide.” The conference report will serve as an important resource, to help facilitate much needed development and evaluation of local initiatives that improve access to home dialysis therapy.