Abstract: TH-PO0493
Kidney Pharmacy Services Reduce Mortality and Hospital Burden in Hemodialysis
Session Information
- Dialysis: Novel Therapeutics and Medication Management
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Martinez, Amanda J, FreseniusRx, Franklin, Tennessee, United States
- Kutovoy, Gennady, FreseniusRx, Franklin, Tennessee, United States
- Grissom, Peyton Hancock, FreseniusRx, Franklin, Tennessee, United States
- Blankenship, Derek, Renal Research Institute, New York, New York, United States
Background
Medication management in end-stage kidney disease is complex and inadequately addressed by traditional pharmacy models. These models often fail to identify and resolve kidney-specific medication problems unique to this population. This study evaluated the clinical impact of a renal-specialized pharmacy model on patient mortality, hospitalization rates, and length of stay.
Methods
We conducted an observational study of 254,859 patients receiving in-center hemodialysis (ICHD), home hemodialysis (HHD), and peritoneal dialysis (PD) from 2/13/23 to 2/13/25. Patients using pharmacy services were compared to controls with inverse probability weighting to adjust for baseline characteristics including demographics and comorbidities. Follow-up continued until modality change, discharge, transplant, or death. Hospitalizations, length of stay, and missed treatments were assessed per patient year. Time-to-event outcomes were analyzed using Cox proportional hazards model and rates were analyzed with Poisson regression.
Results
A total of 56,704 patients received pharmacy services during the study period and were more likely to be younger, employed, commercially insured, and on PD. While characteristics were adequately controlled for ICHD and HHD populations, the PD group was too dissimilar to establish weighted controls. Hemodialysis patients receiving pharmacy services showed lower mortality (HR ICHD 0.66 [CI 0.63-0.68]; HHD 0.64 [CI 0.57-0.71]), fewer hospitalizations (RR ICHD 0.93 [CI 0.92-0.94]; HHD 0.92 [CI 0.90-0.95]), and shorter length of stay (RR ICHD 0.88 [CI 0.87-0.88]; HHD 0.86 [CI 0.85-0.87]) versus controls (Figure 1). Patients within 3 months of dialysis initiation experienced the most benefit, including fewer missed treatments for ICHD (Figure 1).
Conclusion
Use of renal pharmacy services in ICHD and HHD patients was associated with improved clinical outcomes, particularly within the first 3 months of dialysis initiation. Further research is needed to elucidate underlying mechanisms.