Dialysis modalities for the treatment of end-stage kidney disease recommendations
In contrast, homebased therapies such as PD and home HD (HHD) are less frequently used according to the latest available data. In 2013, about 19% of new ESKD patients in Canada were initiated on home PD, while this rate was 0.6% for HHD. For the same year, the prevalence for patients being treated b...
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| Format: | eBook |
| Language: | English |
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Ottawa
CADTH
2017, March 2017
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| Series: | CADTH optimal use report
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| Online Access: | |
| Collection: | National Center for Biotechnology Information - Collection details see MPG.ReNa |
| Summary: | In contrast, homebased therapies such as PD and home HD (HHD) are less frequently used according to the latest available data. In 2013, about 19% of new ESKD patients in Canada were initiated on home PD, while this rate was 0.6% for HHD. For the same year, the prevalence for patients being treated by home dialysis across the country was about 17% for PD and 2.5% for HHD. Based on the potential comparable clinical effectiveness and potential cost savings that home dialysis therapies may yield, it is often argued these therapies, particularly PD, may be underutilized in eligible patients in Canada and other developed countries. Similarly, the literature and jurisdictional input suggest growing interest in other dialysis delivery models, namely, "selfcare" ICHD, "assisted" PD, and HHD. These options may allow for effective clinical results while being potentially less costly than standard ICHD and may also be more desirable from a patient and caregiver perspective. An increasing number of patients with end-stage kidney disease (ESKD) are being initiated on long-term dialysis every year in Canada. According to data published by the Canadian Institute for Health Information in 2013, an estimated 41,931 Canadians were living with ESKD, with most (24,114 or 57.5%) being treated with dialysis. Hemodialysis (HD) and peritoneal dialysis (PD) are the two main types of dialysis provided under Canadian kidney care programs. In all provinces, HD remains the modality most frequently used for new patients who require dialysis, with Newfoundland and Labrador having the greatest proportion of ESKD patients initiated on HD (91%) in 2013. Moreover, for the same year, most Canadian dialysis patients (76%) received incentre HD (ICHD), which describes HD performed in an institution such as a hospital, satellite unit, or a dialysis facility with the assistance of a health care professional. CADTH conducted a health technology assessment (HTA) to inform policy questions through an assessment of the clinical effectiveness, cost-effectiveness, patient experiences and perspectives, ethical issues, and implementation issues of dialysis modalities for the treatment of ESKD. The following policy questions were addressed: Should the provision of homebased selfcare or assisted dialysis (PD or HD) and selfcare ICHD be more widely implemented in the jurisdictions? If so, what strategies and practices could improve implementation and uptake of these different dialysis modalities in the jurisdictions? These recommendations are relevant for ESKD patients deemed eligible for home therapies by their care provider. Selfcare dialysis is defined as the administration of dialysis by a patient and/or caregiver without the assistance of a health care professional. Assisted dialysis involves the administration of dialysis with the assistance of a health care professional |
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| Physical Description: | 1 PDF file (19 pages) |