Abstract: SA-PO675

Effects of a System-Wide Application of a Comprehensive Pre-Dialysis Education Program on Home Dialysis Therapies

Session Information

Category: Dialysis

  • 604 Home and Frequent Dialysis

Authors

  • Hinkamp, Colin A., University of Florida , Gainesville, Florida, United States
  • Segal, Emma Rebecca, University of Florida , Gainesville, Florida, United States
  • Martinez, Teri B., University of Florida , Gainesville, Florida, United States
  • Thomas, Michelle, Dialysis Clinic, Inc., Gainesville, Florida, United States
  • Bozorgmehri, Shahab, None, Newberry, Florida, United States
  • Ozrazgat-baslanti, Tezcan, University of Florida , Gainesville, Florida, United States
  • Shukla, Ashutosh M., University of Florida , Gainesville, Florida, United States
Background

The efficacy of comprehensive pre-dialysis education (CPE) with respect to its ability to improve home dialysis (HoD) choice and utilization, across the unselected, spectrum of prevalent US advanced CKD patients has not been examined.

Methods

We present a retrospective analysis of the first 20 months of our CPE program to show the impact of implementing a new CPE program across the entire spectrum of CKD, in a university CKD population with respect to its impact on HoD choice and utilization. Details of our CPE protocol has been prior published.

Results

Over the first 20 months, 200 patients were referred for CPE, of which 32% (n=63) patients chose not to participate in the awareness effort. Of the 137 patients enrolled, the majority (91%) chose to participate in only one session of CPE whereas 8% and 1% attended 2 and 3 sessions, respectively. At the end of the CPE, 72% chose HoD (69% peritoneal dialysis (PD) and 3% home HD (HHD)) whereas 11% chose in-center HD (IHD) with 17% remaining undecided. Over the 20 months of follow-up, 25% needed initiation of renal replacement therapy therapies. Amongst these, 73% were initiated on HoD. Univariate and multivariate analyses showed that age, gender, race, insurance status, marital status, smoking status, body mass index and comorbidity status (Diabetes/CHF), had no impact on the individual choice of HoD. The institution of CPE program led to an overall 66% (p trend<0.001) increase in utilization of HoD over the first 20 months with HoD representing 32% of all prevalent dialysis subjects.

Conclusion

The results validate that institution of CPE program leads to increase to HoD choice and utilization. We further show that benefits of CPE are not limited to only those with socio-economic privilege.