LONDON, ON – Patients suffering with end-stage renal disease could increase their survival chances by undergoing intensive dialysis at home rather than the conventional dialysis in clinics. A new study by Lawson Health Research Institute shows the potential of more intensive dialysis completed in a home setting.

The study found that patients who underwent intensive dialysis at home have better survival rates than patients who had conventional dialysis in clinics. Intensive dialysis patients also had better blood pressure results and biochemical test values than conventional dialysis patients.

Dr. Gihad Nesrallah, a Lawson researcher, led the observational study comparing at home intensive dialysis and conventional dialysis in clinics. Intensive dialysis at home consists of eight hours of treatment, three to seven nights a week. Conventional dialysis that takes place in dialysis clinics is usually conducted in less than five hours, three days per week.

Dialysis providers and governments are recognizing the benefits of home based dialysis. The Ontario Renal Network has made independent, at home dialysis a priority for funding more frequent or longer term dialysis therapy. More observational studies, such as this one are needed to further investigate why intensive dialysis at home is more beneficial to the survival of patients.

"Strategies to improve survival for persons with end-stage renal disease are needed, and more intensive dialysis represents one of the more promising options that had emerged in the last two decades. We think that patients may wish to seriously consider intensive hemodialysis where possible," said Dr. Nesrallah.

This study, along with other observational studies focusing on kidney dialysis treatment, has the potential to influence policies centered around funding and gaining more resources to help make intensive at home kidney dialysis more readily available.

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WASHINGTON, April 25, 2012 /PRNewswire/ -- On the heels of the first National Summit on Home Dialysis Policy, Summit organizers released a report reflecting the views of the delegates -- leaders in the kidney disease patient, clinician, facility and industry communities -- on federal policy steps to improve utilization of home dialysis for patients who can benefit from this often advantageous form of treatment. Many of the organizers also announced they have formed a new alliance, called the Alliance for Home Dialysis, to advance the recommendations identified at the Summit.

The Summit's "Report of the Delegates" highlights key findings from a March 29th meeting in Washington, DC where experts probed why, despite widely accepted and well-documented benefits of home dialysis — improved outcomes, enhanced patient satisfaction, improved quality of life, and lower costs— fewer than ten percent of the more than 390,000 current U.S. dialysis patients receive treatment at home.  Current rates of home dialysis utilization reflect a steep decline from the 1970s, when almost 40% of U.S. dialysis patients were treated in-home.

Specifically, delegates found that policymakers should work with stakeholders in the dialysis community to confront three areas:

• Accessibility:   Patients and clinicians face array of hurdles in education, training, and infrastructure that hinder equalized access to home dialysis.
• Accountability:  Utilization of home dialysis can be improved through measures within government programs that are designed to recognize and support excellence in the delivery of home dialysis services.
• Aligning Incentives:  Reimbursement policies, regulation of new technologies and other policy incentives can be realigned to better support federal policy goals of expanding access to home dialysis.  

The Report includes 15 recommendations to serve these goals, including that federal policymakers should:

• Maintain parity for home and in-center dialysis in Medicare reimbursement;
• Support home dialysis mentoring programs, particularly those that use existing patients as mentors; and
• Align federal and state regulatory requirements for home therapies, such as revising the Centers for Medicare and Medicaid Services Conditions for Coverage requirements, to reflect differences in home and in-center dialysis.

A copy of the full report can be found at www.homedialysisalliance.org.

Summit supporters will begin work through the new Alliance to dialogue with federal policymakers and advance policy improvements in the three consensus areas that emerged at the Summit.

SOURCE National Summit on Home Dialysis Policy

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When Caleb Lewis was 15, he was faced with not only the loss of his mother, he was told his kidneys were failing.

“The day of my mother’s funeral, I got a call from my doctor saying something was wrong with my blood work,” said Lewis. “It takes its toll. It was quite a traumatic experience for a young boy.”

He received his first kidney transplant in 2000, allowing him to finish school, but in 2003 that kidney failed. He’s been on dialysis ever since, awaiting another kidney transplant.

Through it all Lewis, now 29, has been determined to maintain a positive attitude. The Westboro resident is determined to stay in top shape and has been named the first recipient of the Alive to Strive Fitness Grant, receiving a one-year membership to a local fitness club and some personal training sessions.

Alive to Strive was founded in 2010 and is committed to helping those with chronic kidney disease have a healthy lifestyle.

“I was super excited,” Lewis said of when he found out he won the grant.

His goal is to gain seven kilograms of muscle. He’ll also take part in the Alive to Strive Race, which will be held April 29 at the Terry Fox Athletic Facility.

Joining him will be members of his family who have been incredibly supportive – including his nine- and 11-year-old nieces, Hannah and Holly.

“My family is behind me,” Lewis said, adding they are the reason he maintains such a positive attitude. “There are all of these good things in life. Yes, it’s shadowed by a couple bad things, but those are only a couple bad things.

“There’s so many good things in my life: my nieces, my dog, my house, my friends, my roommate. I have great things in my life and it sucks to dwell on the bad stuff. There’s things you can do for yourself to make your life better, and make everything a positive experience.”

Lewis describes how it can be difficult for other patients on dialysis to maintain a positive attitude, but it’s important for them not to give up.

“To me, being on dialysis isn’t giving up,” he said. “It’s making sure you’re sticking around to be with the ones you live and do the things you want to do.”

The activities Lewis said he enjoys most are snowboarding and skateboarding, and he couldn’t imagine himself being an inactive person.

He also played hockey until he had to stop when he started on dialysis.

“You’ve got to pick and choose what you’re doing in life, and make sure you’re doing the right thing for yourself,” Lewis said.

For more information on Alive to Strive, visit their website at: www.alivetostrive.ca.

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