Effects of a Nationwide Predialysis Educational Program on Modality Choice, Vascular Access, and Patient Outcomes

Lacson, Eduardo; Wang, Weiling; DeVries, Cari; Leste, Keith; Hakim, Raymond M.; Lazarus, Michael; Pulliam, Joseph

doi:10.1053/j.ajkd.2011.04.015

Cited by 150 publications

(150 citation statements)

References 15 publications

Supporting

Mentioning

143

Contrasting

Unclassified

Order By: Relevance

“…Similarly, increasing pre-ESRD programs (29,30) that provide education, emotional support, improved nutrition, and reduce catheters in patients before they start dialysis have the most potential to improve 2-week mortality rates going forward.…”

Section: Discussionmentioning

confidence: 99%

Early Outcomes among Those Initiating Chronic Dialysis in the United States

Chan

Maddux²,

Tolkoff-Rubin³

et al. 2011

Clinical Journal of the American Society of Nephrology

Self Cite

131

144

View full text Add to dashboard Cite

SummaryBackground and objectives Approximately one million Americans initiated chronic dialysis over the past decade; the first-year mortality rate reported by the U.S. Renal Data System was 19.6% in 2007. This estimate has historically excluded the first 90 days of chronic dialysis.Design, setting, participants, & measurements To characterize the mortality and hospitalization risks for patients starting chronic renal replacement therapy, we followed all patients initiating dialysis in 1733 facilities throughout the United States (n ϭ 303,289). Mortality and hospitalizations within the first 90 days were compared with outcomes after this period, and the results were analyzed. Standard time-series analyses were used to depict the weekly risk estimates for each outcome.Results Between 1997 and 2009, Ͼ300,000 patients initiated chronic dialysis and were followed for Ͼ35 million dialysis treatments; the highest risk for morbidity and mortality occurred in the first 2 weeks of treatment. The initial 2-week risk of death for a typical dialysis patient was 2.72-fold higher, and the risk of hospitalization was 1.95-fold higher when compared to a patient who survived the first year of chronic dialysis (week 53 after initiation). Similarly, over the first 90 days, the risk of mortality and hospitalization remained elevated. Thereafter, between days 91 and 365, these risks decreased considerably by more than half. Surviving these first weeks of dialysis was most associated with the type of vascular access. Initiating dialysis with a fistula was associated with a decreased early death risk by 61%, whereas peritoneal dialysis decreased the risk by 87%. ConclusionsThe first 2 weeks of chronic dialysis are associated with heightened mortality and hospitalization risks, which remain elevated over the ensuing 90 days.

show abstract

Section: Discussionmentioning

confidence: 99%

Early Outcomes among Those Initiating Chronic Dialysis in the United States

Chan

Maddux²,

Tolkoff-Rubin³

et al. 2011

Clinical Journal of the American Society of Nephrology

Self Cite

131

144

View full text Add to dashboard Cite

show abstract

“…13,14 Patients with very low literacy may benefit from the use of more elaborate audiovisual training aids (developed at low literacy levels).…”

Section: Adult Learning and Home Hdmentioning

confidence: 99%

Patient selection and training for home hemodialysis

Rioux

Marshall

Faratro

et al. 2015

Hemodialysis International

View full text Add to dashboard Cite

show abstract

“…Recent data suggest that use of iterative CKD education that engages the patient and family and involves patients treated with different dialysis therapies can be successful at increasing the use of home dialysis (84)(85)(86). Moreover, even in patients with unplanned acute-start dialysis, patient education has been associated with successful transition to home dialysis (87).…”

Section: Adequate Patient Educationmentioning

confidence: 99%

How to Overcome Barriers and Establish a Successful Home HD Program

Young

Chan

Blagg

et al. 2012

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Summary Home hemodialysis (HD) is an underused dialysis modality in the United States, even though it provides an efficient and probably cost-effective way to provide more frequent or longer dialysis. With the advent of newer home HD systems that are easier for patients to learn, use, and maintain, patient and provider interest in home HD is increasing. Although barriers for providers are similar to those for peritoneal dialysis, home HD requires more extensive patient training, nursing education, and infrastructure support in order to maintain a successful program. In addition, because many physicians and patients do not have experience with home HD, reluctance to start home HD programs is widespread. This in-depth review describes barriers to home HD, focusing on patients, individual physicians and practices, and dialysis facilities, and offers suggestions for how to overcome these barriers and establish a successful home HD program.

show abstract

Effects of a Nationwide Predialysis Educational Program on Modality Choice, Vascular Access, and Patient Outcomes

Cited by 150 publications

References 15 publications

Early Outcomes among Those Initiating Chronic Dialysis in the United States

Early Outcomes among Those Initiating Chronic Dialysis in the United States

Patient selection and training for home hemodialysis

How to Overcome Barriers and Establish a Successful Home HD Program

Contact Info

Product

Resources

About