Abstract: FR-PO1078
Barriers to Home RRT
Session Information
- Home Dialysis: Modalities, Barriers, Utilization, and Clinical Outcomes
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- King, Akilah, The University of Chicago Medicine, Chicago, Illinois, United States
- Ochoa, Christian A., The University of Chicago, Chicago, Illinois, United States
- Alausa, Maryam, The University of Chicago Medicine, Chicago, Illinois, United States
- McCoach, Enissa, The University of Chicago Medicine, Chicago, Illinois, United States
- Gunning, Samantha, The University of Chicago Medicine, Chicago, Illinois, United States
- Saunders, Milda R., The University of Chicago Medicine, Chicago, Illinois, United States
Background
Home dialysis, peritoneal dialysis and home hemodialysis, remain underutilized treatments despite lower costs and improved quality of life. Black and Hispanic individuals have even lower home dialysis uptake compared to their White counterparts. We sought to identify patient-perceived barriers to home dialysis among minoritized urban patients with ESKD.
Methods
We used a semi-structured interview guide and asked patients receiving care at four academic medical center affiliated dialysis units to rank 21 barriers to home dialysis based on IM-HOME survey questions. We reported the three top ranked barriers.
Results
Our sample included 53 participants (of 260 eligible) across 4 dialysis units; 84.5% participants identified as African American, 5.7% as Hispanic, and 56% male. Of participants, 25% were aged 18-50, 42% were 41-64, and 34% were over 65. Most (58.5%) participants had been on dialysis for less than 4 years, and 17% were using PD. The overall top reported (ranked 1, 2, or 3) were 1) home dialysis is a lot of work/this workload can cause burnout (43.4%), 2) patients have little space at home for the dialysis machine and supplies (39.6%), and 3) new patients may be scared to do their dialysis at home (34.0%).
Conclusion
Space limitations, concerns for burnout, and fear of poor outcomes may contribute to lower uptake of home dialysis in urban minoritized communities. To some patients with ESKD, in-center HD provides social support and trained staff. Our findings highlight the importance of increasing patient knowledge, confidence, and caregiver support to increase home dialysis in minoritized communities.
Top Barriers to Home Dialysis
| Most Important N(%) | 2nd Most Important | 3rd Most Important | Total | Representative Quote | |
| Home dialysis is a lot of work, this workload can cause burnout | 7(13.2%) | 9(17.0%) | 7(13.2%) | 23(43.4%) | I enjoy the convenience of nurses and techs in center |
| Patients have little space at home for the dialysis machine and supplies | 10(18.9%) | 7(13.2%) | 4(7.5%) | 21(39.6%) | Burdensome to have machine at home and clutter |
| New patients may be scared to do their dialysis at home | 8(15.1%) | 4(7.6%) | 6(11.3%) | 8(34.0%) | Concerned if something goes wrong like infections |