Home Dialysis Services

Shift Your Perspective on Home Dialysis

Improved clinical outcomes
Higher quality of life
Lower healthcare costs

A growing number of physicians, patients and payors agree: Home dialysis is the option of 1st choice whenever possible.

In a recent survey including over 500 dialysis facility medical directors, 68 percent of all respondents chose home dialysis when asked to vote for their initial treatment modality of choice if they were personally to need dialysis.¹

The advantages of performing dialysis at home are compelling

As the number of people on dialysis increases every year, and as the financial burden on our healthcare system continues to grow, home dialysis offers a new paradigm for meeting the needs of physicians, patients and payors:

Physicians want improved outcomes
Patients want a higher quality of life
Payors want lower additional costs

Despite evidence suggesting that up to 93 percent of incident patients do not have any medical contraindications for home dialysis, less than 8 percent of dialysis patients receive care at home.²

Home dialysis improves outcomes

The growing evidence of improved outcomes with home dialysis is convincing more physicians to shift perspectives. Lower mortality rates for both peritoneal dialysis³ and home dialysis⁴ are commanding serious consideration. Along with lower mortality comes a host of other benefits.

Home dialysis improves quality of life

Home dialysis improves the quality of life (QOL) for patients by eliminating the weekend interval without dialysis and the cycle of trips to and from the clinic. Improvements in QOL begin with the alleviation of multiple symptoms related to a feeling of well-being. Working patients, for example, not only need a treatment plan that accommodates their schedules, but also must feel well enough to do their jobs. Home dialysis reduces multiple symptoms to improve patient functionality.

The number of dialysis patients of working age that are actually working is nearly 30 percent.⁶

Home dialysis lowers healthcare costs

In addition to improved outcomes and higher quality of life, lower additional patient costs are winning payor support for the “paradigm shift” to home as well.²

Lower hospitalization and transportation costs for home patients are easily recognized by payors as having a cost savings potential. In order to optimize these cost savings, however, they would need to encourage an increase in home dialysis utilization. The cost savings realized from this shift to home dialysis could then be better spent to help balance the budget as the chronic kidney disease population continues to grow.⁷

As of 2008, Medicare Conditions for Coverage require patient education and participation in choice of modalities.⁸ These changes and others will help realize the above benefits as more patients choose to dialyze at home.

At Fresenius Medical Care, returning a patient to being a participating member of society is the ultimate measure of outcome success.

Visit Fresenius Kidney Care to learn how our services makes home dialysis more convenient.

Supporting physicians who wish to grow home dialysis programs is one of our critical success factors. Expanding our physician education offerings, providing easy access to specific and up-to-date home dialysis information, and providing you with a direct source of home dialysis expertise is how we stand behind our commitment to home dialysis.

Directors of home therapies:

Your Fresenius Medical Care contact for clinical and operational support is your regional Director of Home Therapies. These highly experienced home dialysis experts are the “best of the best” and are well-versed in licensing, regulatory, compliance, reimbursement and financial matters related to home dialysis.

24/7 Home dialysis nursing coverage:

Our home dialysis nurses provide 24/7 coverage for our home patients. Experienced in both home hemodialysis and peritoneal dialysis, our nurses are able to address most dialysis-related issues.

The Advanced Renal Education Program (AREP):

A series of didactic seminars dedicated to renal professionals
This program is an especially useful resource for physicians making the shift to home dialysis
The AREP website also provides extensive online resources for physicians on a variety of topics

Please visit us at www.advancedrenaleducation.com.

Nurses and patient care staff are the backbone of our home dialysis programs. Fresenius Medical Care provides them with all the training, materials and support they need to ensure your patients achieve their goals at home.

Home dialysis policies and procedures

When implementing any new program, it’s best to start with a basic understanding and agreement on policies and procedures. With years of experience behind us and constant updates with current best practices, our policies and procedures have become a de facto standard in the industry.

Home dialysis nurse training

Our nurse training program, with separate staff training materials for peritoneal dialysis and home hemodialysis, helps to ensure that a consistent level of clinical practice is established early in a program’s history.

Home dialysis patient training

For peritoneal dialysis or home hemodialysis, our user-friendly step-by-step patient training materials emphasize adult learning fundamentals.

Staff Mentoring Program

Our home dialysis nurses receive not only extensive training, but mentoring as well. Our Staff Mentoring Program forges nurse-nurse relationships focused on sharing experiences, building confidence, and growing a commitment to continuous quality improvement.

At Fresenius Medical Care, we are reaching out to people in order to increase awareness of kidney disease, and to let people know the importance of early diagnosis and treatment.

Treatment Options Program

In response to the growing interest in home dialysis, Fresenius Medical Care created a new pre-ESRD education program. This program teaches patients about the various forms of renal replacement therapy and emphasizes the importance of early diagnosis and treatment. Please refer your patients to this program early so they will be well-prepared to discuss their treatment modality options with you, and together you can choose the best treatment for them.

Home Hemodialysis

Growing interest in home hemodialysis has created a demand for greater access to this treatment modality. Whether it is working with patients and families to train care partners, or providing clinical or technical expertise in patients’ homes, Fresenius is working to make home hemodialysis a more accessible option.

Staff Assist Program

This program is an option for qualified patients to get their hemodialysis treatments from a certified Fresenius caregiver in the comfort and privacy of their own homes.

Peritoneal Dialysis

Fresenius is also working to expand the underutilized role of peritoneal dialysis by making more people aware of this option early in the progression of their chronic kidney disease. Products such as the stay●safe^® CAPD system and the Liberty™ cycler are making peritoneal dialysis easier and more convenient than ever before.

Footnotes:

J. Pulliam, et al. Fresenius Medical Services, Medical Directors Meeting 2007
Rajnish Mehrotra, et al. Chronic Peritoneal Dialysis in the United States: Declining Utilization Despite Improving Outcomes. JASN. 2007; 18:2781-2788.
Osman Khawar, Kamyar Kalantar-Zadeh, Wai Kei Lo, David Johnson, Rajnish Mehrotra. Is the Declining Use of Long-Term Peritoneal Dialysis Justified by Outcome Data? Published ahead of print on October 17, 2007. Clin J Am Soc Nephrol. 2007; 2:1317-1328.
Belding H. Scribner and Zbylut J. Twardowski. The Case for Every-Other-Day Dialysis. Hemodial Int. 2000; 4:5-7.
Joanna M. Bargman and Thomas A. Golper. The importance of residual renal function for patients on dialysis. Nephrology Dialysis Transplantation. 2005; 20:671-673.
Louise M. Moist, et al. Travel Time to Dialysis as Predictor of Health-Related QOL Adherence and Mortality: The Dialysis Outcomes and Practice Pattern Studies (DOPPS). AJKD. 2008; 51:641-650.
The USRDS Dialysis Morbidity and Mortality Study (Wave 2). USRDS Annual Data Report Chapter IV. 1997; 49-67d.
Federal Register Part II, Dept. of Health and Human Services, Centers for Medicare & Medicaid Services. Conditions for Coverage for ESRD Facilities, Final Rule. 2008
Status of the Social Security and Medical Programs: A Summary of the 2008 Annual Reports. Accessed at www.ssa.gov.