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Kidney Week

Abstract: FR-PO254

Longitudinal Kidney Care Program and Its Impact on Decreasing Hospitalizations and Increasing Home Dialysis as the First Choice for Dialysis

Session Information

Category: CKD (Non-Dialysis)

  • 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Balamuthusamy, Saravanan, PPG healthcare, Fort Worth, Texas, United States
  • Govindaraju, Aruna, PPG Health, Fort Worth, Texas, United States
  • Ellappan, Manonmani, PPG Health/ TRI, Fortworth, Texas, United States
  • Dhelaria, Ranjit Kumar, PPG Healthcare, Fort Worth, Texas, United States
  • Reddi, Alagarsamy l, Texas Research Institute and PPG Healthcare PA, Fort Worth, Texas, United States
  • Veerappan ganesan, Roshni, Texas Research Institute, Fort Worth, Texas, United States
  • Sankarapandian, Balamurugan P, PPG Healthcare, Fort Worth, Texas, United States
Background

The economic and morbidity burden of kidney disease has substantially increased in the past decade. With innovations on the pipeline for novel dialysis modalities, there is a lack of system-based practice applications in patients with kidney disease to decrease hospitalizations. We have initiated a systematic approach in educating patients with renal failure based on risk of progression to end stage kidney disease and assessed its efficacy in decreasing hospitalizations.

Methods

Retrospective analysis of patients in our nephrology practice who were hospitalized between January 2017 to January 2018. Also the rates of early home dialysis initiation were analyzed. ESRD patients were not included in the analysis for hospitalizations. The reason for hospitalizations were based on the admission diagnosis.

Results

The database included 4367 patients at low risk of progression and 1954 patients at a higher risk of progression based on the NKF heat map. The aggregate episode rate for hospitalization per 100 patients was calculated. The rate of hospitalizations was computed for three years. The first year serves as a control as the LKCP was not initiated at that time. The 2 years after that is when the program was actively implemented. The results are shown in Figures 1 and 2.

Conclusion

There is a significant reduction in hospitalizations and early initiation of home dialysis with a well-structured kidney care program that includes a multidisciplinary approach. These methods need to be validated in a much larger cohort for mortality risk and cost savings calculated with real time data from payors.