Abstract: FR-PO531
The KIDNEY-CAP: A Novel Device in the Management of Bleeding in Intermittent Hemodialysis Patients
Session Information
- Dialysis Vascular Access
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 803 Dialysis: Vascular Access
Authors
- Forster, Adam, Western University Schulich School of Medicine & Dentistry, London, Ontario, Canada
- Rehman, Faisal, Western University Schulich School of Medicine & Dentistry, London, Ontario, Canada
- Thomson, Benjamin K., Johns Hopkins University, Baltimore, Maryland, United States
Group or Team Name
- KIDNEY-CAP.
Background
Out of hospital arteriovenous graft (AVG) and arteriovenous fistula (AVF) bleeding occurs in 1-3/1000 hemodialysis patients per year. It is associated with hospitalization, hemorrhagic shock, and death. Presently there are no approved out of hospital devices available to aid patients if they develop an out of hospital bleed. The KIDNEY-CAP is a 3D printed cap that has been developed for patient use in this scenario. This study assessed attitudes towards vascular access, transplantation, and home dialysis in nephrology health care workers (NHCs) such as nephrologists, nephrology nurse practitioners, and body access coordinators, as well as ESKD patients on hemodialysis (ESKD-D) and how the KIDNEY-CAP influences these impressions.
Methods
Survey 1 studied KIDNEY-CAP introduction into the CKD/ESKD patient experience, and how it would impact NHC recommendations for kidney care. Parameters such as recommendation for transplantation, vascular access modality, and home dialysis opportunities were explored. In survey 2, in-center ESKD-D patients were evaluated for how the KIDNEY-CAP might modify decisions regarding their end stage kidney disease care. When survey respondents already had an AVG/AVF, their level of concern regarding AVG/AVF bleeding was quantified, while evaluating for common bleeding risk factors.
Results
In survey 1, 41% of respondents indicated that they were more likely to recommend home dialysis and vascular access with AVG/AVF if a KIDNEY-CAP was available. Providers were more likely to recommend these options in patients not yet on dialysis. In survey 2, 66% of patients indicated at least slight concern about bleeding from their access site. 66% also felt they would benefit from having a device to help control bleeding outside the dialysis unit. 27.8% indicated that they would be more likely to select AVG/AVF as their vascular access of choice if they had a KIDNEY-CAP. There was no difference in feelings toward home dialysis or transplantation.
Conclusion
We demonstrate that the KIDNEY-CAP is a device of interest for providers in determining vascular access for patients approaching dialysis. There may also be benefit to patient comfort with vascular access should the KIDNEY-CAP be available. Further exploration in the predialysis patient population is warranted, as is prospective study on the KIDNEY-CAP's adoption.