VIDEO: Transition costs are high when patients switch from PD to HHD
BOSTON — In this video from the National Kidney Foundation Spring Clinical Meetings, Eric D. Weinhandl, PhD, MS, talks about the hidden costs in helping patients transition from peritoneal dialysis to home hemodialysis.
“Increasing use of peritoneal dialysis (PD) will likely lead to increasing numbers of patients transitioning from PD to hemodialysis (HD),” Weinhandl, an epidemiologist at the Hennepin Healthcare Research Institute in Minneapolis at the time the research was completed, and colleagues wrote in a poster presented at the meeting.
Researchers used the U.S. Renal Data System to identify patients aged 12 years and older who were newly diagnosed with end-stage kidney disease from 2001 through 2017. Of this group, the staff identified patients who initiated PD during the first year of ESKD, and discontinued PD from 2009 to 2018.
“We estimated monthly rates of hospital admissions, observation stays, emergency department encounters and Medicare Parts A and B costs during the 12 months before and after conversion from PD to HD, as well as the incidence of home HD initiation, kidney transplantation and death after conversion to in-facility HD,” Weinhandl and colleagues wrote.
Results showed rates of acute care and total Medicare spending rose sharply during the 6 months before discontinuing PD, due to hospitalizations for PD catheter complications, cardiovascular disease and peritonitis.
“The transition from PD to HD is characterized by high rates of both acute care encounters and health care expenditures,” Weinhandl wrote. “Quality improvement efforts should be aimed at improving transitions and encouraging both home HD and transplantation after discontinuation of PD.”