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Abstract: TH-PO320

The Effect of Implementing a Dialysis Start Unit on Modality Decision Among Patients with Urgent Start Kidney Replacement Therapy

Session Information

  • Home Dialysis - I
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis


  • Goldman, Shira, University of Toronto, Toronto, Ontario, Canada
  • Bargman, Joanne M., University of Toronto, Toronto, Ontario, Canada
  • Lok, Charmaine E., University of Toronto, Toronto, Ontario, Canada
  • Gozdzik, Anna Maria, University of Toronto, Toronto, Ontario, Canada
  • Perl, Jeffrey, University of Toronto, Toronto, Ontario, Canada
  • Chan, Christopher T., University of Toronto, Toronto, Ontario, Canada

Many individuals start dialysis in an acute setting with suboptimal pre-dialysis education. The dialysis start unit (DSU) is a program performing in-center hemodialysis (HD) in a separate space while providing support and education on chronic kidney disease and treatment options in the initial weeks of kidney replacement therapy. We aimed to assess the uptake of home dialysis therapies between 2013-2021 among patients who started acute inpatient HD at University Health Network, Toronto and underwent dialysis at the DSU.


This is a retrospective observational cohort study based on prospectively collected data. Patients’ demographics were obtained from electronic charts. In the DSU, all patients received dialysis modality education by a nurse educator, dedicated home dialysis nurses, and the allied health care team.


During 2013-2021, 122 patients were dialyzed in the DSU and included in the study. Among those patients, 68 patients ultimately chose home dialysis (57 peritoneal dialysis and 11 home HD). Fifty-four patients continued in-center HD. Patients adopting home dialysis were less likely to have diabetes and hypertension as the etiology of kidney failure and more likely to have glomerulonephritis or vasculitis.


Dialysis modality education is implementable in advanced chronic kidney disease. Individualized education and care after urgent start dialysis can potentially enhance home dialysis choice and utilization.

Patients demographics and comorbidities

Modality selection among DSU patients