Utilization of Home Dialysis and Permanent Vascular Access at Dialysis Initiation Following a Structured CKD Education Program

McKeon, Katherine; Sibbel, Scott; Brunelli, Steven M.; Matheson, Erin; Lefeber, Nick; Epps, Meghan; Tentori, Francesca

doi:10.1016/j.xkme.2022.100490

Cited by 5 publications

(1 citation statement)

References 18 publications

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“…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). 13 The same study also showed lower incidence of hospitalization and overall mortality in the first year after dialysis initiation in the group that received education. There is currently a randomized control trial (NCT04064086) underway to study these outcomes further for patients with advanced CKD.…”

Section: Education and Preparednessmentioning

confidence: 74%

Systems Innovations to Increase Home Dialysis Utilization

Cheng,

Chan

2023

CJASN

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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.

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Section: Education and Preparednessmentioning

confidence: 74%

Systems Innovations to Increase Home Dialysis Utilization

Cheng,

Chan

2023

CJASN

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Patient Perspectives on Arteriovenous Fistula Placement, Maturation, and Use: A Qualitative Study

Patel,

Churilla,

Lee

et al. 2024

Kidney Medicine

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Knowledge, Attitudes, and Practices Towards Exercise Therapy Among Patients with Stage 5 Chronic Kidney Disease on Regular Hemodialysis

Chai,

Gu,

Fan

et al. 2024

IJGM

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Background Exercise therapy could improve physical and psychological health in patients with chronic kidney disease (CKD). This study aimed to investigate knowledge, attitudes and practices (KAP) towards exercise therapy among patients with CKD stage 5 on regular hemodialysis. Methods The cross-sectional study was conducted between August 1st and 30th, 2023; KAP and demographic characteristics of CKD-5 patients were assessed with self-distributed questionnaire and analyzed using logistic regression and structural equation modeling (SEM). A higher score represented better knowledge, more positive attitude, and more proactive practice. Results In 513 collected questionnaires, mean scores for knowledge, attitudes, and practices were 9.5 ± 4.1 (possible range: 0–13), 31.9 ± 5.0 (possible range: 9–45), and 21.7 ± 9.3 (possible range: 9–45). Multivariate logistic regression analysis showed that education (OR = 1.8, 95% CI: 1.1–3.0, P = 0.02), income (OR = 1.7, 95% CI: 1.1–2.6, P = 0.02), and family support (OR = 3.8, 95% CI: 2.0–7.1, P < 0.001) were independently associated with higher knowledge scores. Knowledge score (OR = 5.1, 95% CI: 1.7–15.1, P < 0.001) and attitude score (OR = 7.3, 95% CI: 3.7–14.2, P < 0.001) were independently associated with higher practice scores. According to SEM, knowledge directly influenced attitude (β=1.3, P < 0.001), while attitude influenced practice (β=0.8, P < 0.001). Conclusion Patients with CKD-5 who underwent regular hemodialysis demonstrated insufficient knowledge, passive attitude and inactive practices towards exercise therapy. Improving knowledge and attitude through educational interventions might result in better practice.

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Utilization of Home Dialysis and Permanent Vascular Access at Dialysis Initiation Following a Structured CKD Education Program

Cited by 5 publications

References 18 publications

Systems Innovations to Increase Home Dialysis Utilization

Systems Innovations to Increase Home Dialysis Utilization

Patient Perspectives on Arteriovenous Fistula Placement, Maturation, and Use: A Qualitative Study

Knowledge, Attitudes, and Practices Towards Exercise Therapy Among Patients with Stage 5 Chronic Kidney Disease on Regular Hemodialysis

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