NN&I - June 2010

Home Dialysis Update June 2010 Nephrology News & Issues 35Subscribe to our free eNewsletter at www.nephronline.com 1-888-DaVita-8 l DaVita.com/NNI Live and on-demand webinars, led by respected physicians, that include various topics on: Get the latest information on home dialysis from leading physicians. To join: 1-888-DaVita-8 l DaVita.com/NNI Live and on-demand webinars, led by respected physicians, that include various topics on: Get the latest information on home dialysis from leading physicians. To join: Bundle could lead to more PD therapyA research report released April 21 sug-gests even with a lack of patient enthu -siasm, the new bundling payment sys- tem could still lead to an increase in the use of home modalities, particularly peritoneal dialysis (PD). The latest data from BioTrends Re- search Group showed that the majority of medical directors and dialysis nurses surveyed expect their use of perito -neal dialysis and home hemodialysis to increase in the near future. This change is mainly financially driven by the new bundled payment system, but many nephrologists have said in previ-ous surveys that home therapies need to be offered to patients more often. The report is based on responses to an online survey completed by 78 dialysis center medical directors and 34 dialysis nurses. Despite the fact that the vast majority of U.S. dialysis patients are currently treated with in-center hemodialysis, 98% of the medical direc-tors surveyed would choose a home modality for themselves if they needed dialysis, according to the report.PD popularity growing with acclimated elderlyPatients older than 65 tend not to choose peritoneal dialysis (PD) for many reasons. But a recent study suggests that PD may be preferable to hemodialysis in the elderly who have the cognitive and functional abil-ity to perform the therapy. The BOLDE (Broadening Outcomes for Long-term Dialysis in the Elderly) trial, completed in the United Kingdom, looked at health-related quality of life measures in PD vs. HD patients older than 65. The data was presented at the Annual Dialysis Conference in Seattle in March. Using a cross-sec-tional design, the study matched PD and HD patients (age, gender, time on dialysis) and compared health-related quality of life via several vali- dated assessment tools. The average patient age was 73, and most were men (70%), with 25% living alone in both groups. Patients in both groups were on dialysis, on average, for about two and a half years. Education levels were similar in both groups. The study also found that depres-sive symptoms were less common in the PD group, as were common dialysis-associated symptoms (head-aches, dry mouth, taste changes, and dizziness), with the exception of lower extremity edema, which was more common in patients with PD. HD Update_NNI0610_4.indd 35 5/14/10 4:50:08 PM