Abstract: SA-PO471
Connected Home Hemodialysis Machine Use and Transition to In-Center Hemodialysis
Session Information
- Home Dialysis - 2
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Hurtado, Miranda, DaVita Inc, Denver, Colorado, United States
- Zywno, Meredith L., DaVita Inc, Denver, Colorado, United States
- Weinhandl, Eric D., Davita Clinical Research, Minneapolis, Minnesota, United States
- Naljayan, Mihran V., DaVita Inc, Denver, Colorado, United States
Background
Although home hemodialysis (HHD) has been growing rapidly, ongoing expansion is constrained by relatively high rates of transition to in-center hemodialysis (ICHD) during the first year of therapy. We aimed to assess whether the use of an internet-connected home hemodialysis machine (CC), which employs a tablet and relays treatment data to dialysis providers, was associated with a decreased rate of transitioning to ICHD.
Methods
The study population included all HHD patients who began treatment in a large dialysis provider organization between July 2021 and December 2022 and initiated use of a CC [NxStage System One with Nx2me Connected Health, Fresenius Medical Care] within 30 days of first documented treatment. Patient data were obtained from electronic medical records and initiation of CC was ascertained from electronic treatment records. Patients were followed from 30 days after HHD initiation until the earliest of transition to ICHD, death, kidney transplant, or end of study follow-up. Kaplan-Meier estimation and Cox regression were used to compare technique survival in CC and non-CC patients at 90 days and 360 days; death and transplantation were classified as censoring events.
Results
The study cohort included 1,563 patients, among whom 930 (60%) used a CC. Mean age among patients was 55.8 years, and 39% of patients were female. In the HHD patient population, CC and non-CC patients had no significant difference in risk of transitioning to ICHD (HR: 1.00, 95% CI: 0.82, 1.21). However, when follow-up was limited to the first 180 days, CC patients experienced a 22% lower rate of transition to ICHD, compared to non-CC patients (HR: 0.78, 95% CI: 0.61, 1.00).
Conclusion
The use of a CC was not associated with a differential risk of transition to ICHD from HHD in our study population, although there was evidence of potential benefit during the first 6 months. More study is needed to determine whether this technology could positively impact home modality retention.