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Abstract: SA-PO341

Differences in Demographic and Clinical Outcomes Between Modalities for Patients 60 Days Post-Transitional Care Unit Initiation

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Blankenship, Derek M., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
  • Kraus, Michael A., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
  • Chatoth, Dinesh K., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
  • Lasky, Rachel A., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
  • Usvyat, Len A., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
  • Maddux, Franklin W., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
Background

Transitional Care Units (TCUs) are designed to enhance patient support at time of dialysis initiation and provide comprehensive education on renal replacement therapies. Much remains to be learned about TCUs and their performance. As an initial step, the purpose of this study is to describe and compare the demographics and clinical characteristics by patients’ modality at 60 days post TCU enrollment.

Methods

This retrospective study identified Fresenius Kidney Care (FKC) patients new to dialysis and starting incenter hemodialysis (ICHD) within a TCU between Oct. 1st, 2019 and Sept. 30th, 2020. Patients less than 18 years of age and with Acute Kidney Injury preceding End Stage Kidney Disease were excluded. Demographic and clinical outcomes were measured 60 days post TCU enrollment. Tests for differences among modalities were conducted using Kruskal-Wallis and Chi-Square tests.

Results

725 patients who initiated treatment at one of 57 TCUs were studied. After 60 days, 9.5%, 10.5%, 70.1%, and 9.9% were on peritoneal dialysis (PD), home hemodialysis (HHD), ICHD, or remained within a TCU, respectively. Gender, race, US region, educational status, albumin, BMI, and vascular access type were statistically significant between modalities (p<0.10). Of note, ICHD and PD had a higher proportion of female patients than HHD and those remaining in a TCU (42 vs 29%). Similarly, ICHD and PD had a higher patient proportion who live in the south (22 vs 8%). ICHD had a lower proportion with college or higher education (36 vs 49-52%) and higher proportion of blacks (45 vs 26-41%). Lastly, HHD had a higher mean BMI than other modalities (33 vs 27-29). Age, ethnicity, primary cause of ESRD, and history of diabetes, heart failure, and coronary heart disease were not statistically significant.

Conclusion

This preliminary study identified several demographic and clinical differences between modalities and could be used for TCU enhancements. Selection bias for patients referred to a TCU is likely. In the future, TCUs should be available for all patients and long-term follow-up of clinical outcomes should be assessed.

Funding

  • Commercial Support – Fresenius Medical Care