Abstract: TH-PO1271
The ODYSSEE-Kidney Health Trial for Home Kidney Replacement Therapy (KRT)
Session Information
- Late-Breaking Research Posters
October 22, 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
- Chan, Christopher T., University Health Network, Toronto, Ontario, Canada
- Nolan, Robert, University Health Network, Toronto, Ontario, Canada
Group or Team Name
- on behalf of the ODYSSEE-Kidney Health Team
Background
Task force guidelines for patients with chronic kidney disease (CKD) advocate informed decision-making about home-based KRT. We hypothesized that automated digital counseling + Usual Care (ODYSSEE/UC) vs. UC alone would increase the incidence of home KRT: composite index of home-based peritoneal- or hemo-dialysis, or evaluation for kidney transplant.
Methods
A 2-arm, parallel group, single-blind randomized controlled trial was used with 1:1 allocation ratio to ODYSSEE/UC vs. UC. Median monitoring of incidence of home-KRT was12 months (range = 4-22). Secondary outcomes included days to home-KRT, and self-reported motivational readiness at baseline. Primary outcome was analysed using binary logistic regression. Secondary analyses used binary logistic regression and Cox proportional hazards models to evaluate potential interactions between ODYSSEE/UC vs. UC and Readiness in association with home-KRT initiation, and days to first home KRT event. Post-hoc Bayesian multivariable logistic regression analysis assessed the probability of our findings.
Results
CKD patients (n = 158) were 70% male, mean age = 62±16 years, and 2-year, 4-variable kidney failure risk equation = 45±28. 32 patients initiated home KRT and it was not associated with ODYSSEE/UC vs. UC: OR = 1.5, (95%CI, 0.7, 3.2); but it was associated with a Group * Readiness interaction: OR = 16.6, (95%CI, 1.7, 157.2). Patients in ODYSSEE with self-reported Readiness were more likely to initiate home-KRT (Figure 1). Bayesian analyses indicated that ODYSSEE patients with baseline Readiness had higher odds of initiating home KRT: OR = 4.71 (95% Crl, 1.65 – 13.37), posterior probability of OR > 1 = 99.8%. In addition, ODYSSEE patients who were Ready had enhanced probability of initiating home KRT, but this effect was imprecise: OR = 1.73 (95% Crl, 0.73-4.14), posterior probability of OR > 0 = 89%.
Conclusion
Patient motivation is prospectively associated with initiation of home-KRT or transplant evaluation. This raises the challenge of incorporating procedures in digital counseling to enhance motivation to make informed choices about home-KRT.
Acknowledgment
This trial was funded by CIHR.
Funding
- Government Support - Non-U.S.