Abstract: FR-OR077
Conversions to Hemodialysis for Patients on Peritoneal Dialysis Admitted to Skilled Nursing Facilities in the United States, 2012-2022
Session Information
- What's New at Home (Dialysis)?
November 07, 2025 | Location: Room 351D, Convention Center
Abstract Time: 05:10 PM - 05:20 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Knapp, Christopher D., Hennepin Healthcare Research Institute Chronic Disease Research Group, Minneapolis, Minnesota, United States
- Li, Shuling, Hennepin Healthcare Research Institute Chronic Disease Research Group, Minneapolis, Minnesota, United States
- Kou, Chuanyu, Hennepin Healthcare Research Institute Chronic Disease Research Group, Minneapolis, Minnesota, United States
- Johansen, Kirsten L., Hennepin Healthcare Research Institute Chronic Disease Research Group, Minneapolis, Minnesota, United States
Background
Despite growth in the Peritoneal Dialysis (PD) population and the number of dialysis facilities offering PD since 2011, PD patients who are admitted to skilled nursing facilities (SNFs) have become more likely to receive hemodialysis (HD) over this period. The objective of this study was to examine the timing of receipt of HD and SNF-level temporal trends in the percentage of PD patients remaining on PD during admission.
Methods
We used the US Renal Data System to identify yearly point prevalent adult PD patients with Medicare fee for service coverage who had first SNF admission in the years 2012-2022. We also examined the timing of conversion to HD in the subgroup of yearly cohorts 2020-2022 combined that received HD within 30 days of admission. We then examined SNF-level trends in retaining PD within 5 days of admission from 2012-2022. We used Medicare claims to identify SNFs that admitted PD patients, and categorized SNFs by how often PD patients remained on PD after admission (almost never [<11%], sometimes [11-89%], or almost always [≥90%]).
Results
From 2020-2022, 3488 PD patients were admitted to SNFs at least once for a total of 3603 patient-year observations, of whom 31.4% received HD within 30 days of admission. The median time-to-receipt of HD after admission was two days (IQR, 2-4 days), and 90% received HD within the first five days of admission. Few SNFs (28% of admitting facilities) admitted more than 1 PD patient per year. Since 2012, the percentage of SNFs in which patients almost always remained on PD decreased from 63% to 41% (Figure 1). The number of SNFs that admitted PD patients decreased from 958 in 2012 to 801 in 2022.
Conclusion
PD patients frequently receive HD within a few days of admission to a SNF, and the number and percentage of SNFs in which PD patients remain on the modality have decreased. As a result, PD patients that require SNF services, even for only short-term rehabilitation, now face higher barriers to maintaining PD than in 2012.
Funding
- NIDDK Support