Feds Pave The Way To Expand Home Dialysis — But Patients Hit Roadblocks

Home dialysis for older adults will become more common in the years ahead, experts predict — but not without overcoming significant challenges. By 2025, the Trump administration wants 80% of people newly diagnosed with kidney failure to receive home dialysis or kidney transplants, according to an executive order issued in July. Currently, more than 85% of such patients are treated at dialysis centers. In a notable move, retail health giant CVS Health has said it will enter the dialysis business, while the companies that dominate this market — Fresenius Medical Care and DaVita — have confirmed plans to expand their home dialysis offerings.

“We think there’s definitely an opportunity to get more of our patients home,” said Dr. Dinesh Chatoth, associate chief medical officer at Fresenius, which this year bought NxStage Medical, a leading provider of home dialysis technology. (About 12% of Fresenius’ 208,000 U.S. dialysis patients are on home therapies.)

“I think it’s realistic to expect 40% to 50% of patients to be able to do home dialysis,” said Dr. Martin Schreiber, chief medical officer for DaVita home modalities. (About 13% of DaVita’s 203,000 U.S. dialysis patients now receive home therapies.)
Other experts think that’s optimistic. “I think 25% to 30% of patients is more realistic,” said Dr. Thomas Golper, a professor of medicine at Vanderbilt University, whose home dialysis program is among the largest in country.

Home dialysis has several advantages over dialysis in treatment centers: Patients can get therapy more frequently, which puts less stress on their bodies; it’s more convenient; it’s less expensive; and patients’ quality of life is generally better, according to numerous studies. On the downside, doing this therapy at home can be isolating, fraught with anxiety, technologically challenging and burdensome for patients and caregivers.--> READ MORE