In June 2019, President Trump signed the Advancing American Kidney Health Initiative (AAKHI) executive order, which aims to reduce the number of chronic kidney disease (CKD) patients who progress to kidney failure by 25%. The order also sets a goal to see 80% of patients with kidney failure treated either with home dialysis or kidney transplants, following an industry trend of moving dialysis patients to at-home treatment.
With the increasing shift to home dialysis, there are strong implications for clinical research involving end-stage kidney disease patients. The transition to home dialysis provides several opportunities for improved clinical research, as discussed below.
Opportunities for Home Dialysis and Clinical Research
Increased Patient Retention
According to Alix Singh, DaVita’s Director of Clinical Services for Home, clinical research can help identify clinical and psychosocial outliers that may cause a patient to stop dialysis treatments. Peritoneal dialysis (PD) patients historically report 2.3 years on therapy, which is suboptimal from a retention standpoint. Integrating triggers in research for patients with a high risk of ceasing therapy can help teams focus on these patients with actionable items to increase retention by preventing involuntary modality conversions.
With the increasing focus towards home dialysis, it will be important for researchers to establish routine touchpoints and connections to garner a broader awareness of clinical research opportunities, says Singh. These touchpoints can help shape future dialysis opportunities and provide an increased understanding of the home dialysis population demographics. This data, in turn, can be used by internal home teams to innovate resources to help make PD or home hemodialysis therapies more available to clinically appropriate patients.
Better Adherence to Treatment
Singh highlights that patients who dialyze at home tend to be more adherent with their treatment regimen and usually have a better support system, providing more opportunities for clinical research.
Increased Post-Transplant Research
A major opportunity for clinical research comes from post-transplant patients, says Singh. If researchers could obtain consent from transplant patients to follow them after surgery, there are significant insights that could be documented to help understand factors that may be contributing to the success or failure of a transplant. These determinants can then be applied to post-transplant education and care to support a higher transplant success rate.
As the shift to at-home dialysis mandated by the AAKHI continues, the team at DaVita Clinical Research continues to conduct essential research into kidney care to help improve patients’ quality of life. To learn more about how DCR supports home dialysis patients, explore our research today.