Learn how Bill’s open dialogue with his nephrologist about his quality of life helped him transition from one home modality to another.
Setting Expectations with Your Patients Early and Often is Crucial for Success.
Most dialysis patients will be prescribed multiple modalities over the course of their treatment. You play an important role in anticipating, planning for, and addressing these transitions. While conversations about modality transitions may be difficult, they are important in your efforts to coach and motivate your patients through their clinical and emotional dialysis journey.
Building Foundations for the Future by Planning Ahead
In the first few months of home dialysis therapy, the risk of transitioning to another modality is at its highest.1 In particular, PD attrition rates are often a result of various clinical concerns but when PD attrition occurs it can be extremely difficult both physically and emotionally for patients.2
Home is Still an Option
Having open conversations with your patients throughout their dialysis journey and clearly indicating the potential for a modality transition will help set their expectations.
Home hemodialysis can be prescribed for some of the same reasons that PD was prescribed:
- Opportunity to take control of their own care
- Greater ability to work and participate in “normal” activities
- Reduced need to travel to and from a dialysis center
- Enhanced freedom from rigid in-center schedules
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- Weinhandl, E.D., Gilbertson, D.T., Collins, A.J. Mortality, hospitalization, and technique failure in daily home hemodialysis and matched peritoneal dialysis patients: a matched cohort study. Am J Kidney Dis. 2016;67:98–110.
- Chaudhary K. Peritoneal Dialysis Drop-out: Causes and Prevention Strategies. Int J Nephrol. 2011. Doi:10.4061/2011/434608.