Kidney Week 2025 Early Program - Home Dialysis: Expanding Access to Home Therapies in 2025 and Beyond-Summary and Wrap-Up: Key Messages

Video Transcription

Video Summary

The session concludes with an audience Q&A on home dialysis. Panelists discuss “tandem” or hybrid dialysis—using PD plus intermittent hemodialysis (e.g., once-weekly HD with six days of PD) to improve fluid control and adequacy, noting Japanese experience and potential concern for encapsulating peritoneal sclerosis. In the U.S., billing and operational barriers often limit implementation. They address PD catheter placement in patients with other abdominal devices: nephrostomy tubes are generally not a concern; PEG tubes require careful timing (better before PD and well-healed; PEG after PD is high-risk for peritonitis); ostomies may be feasible with controlled underlying disease and alternative exit sites. For polycystic kidney disease, speakers note PD can work well, with attention to increased intra-abdominal pressure; outcomes data are reassuring. Logistics for home programs include vendor tech support, water testing, and a detail-oriented center team. Modern gadolinium MRI contrast rarely necessitates PD prescription changes. For calciphylaxis, PD patients may switch to HD to facilitate sodium thiosulfate, though intraperitoneal dosing is possible but can cause nausea or chemical peritonitis and evidence is limited. The meeting ends with ISPD education resources and conference announcements.

Asset Subtitle

Matthew B. Rivara, Jenny I. Shen

Meta Tag

Module DIAL

Speaker CO-CHAIRS CO-CHAIRS

Keywords

home dialysis Q&A

tandem hybrid dialysis PD plus intermittent hemodialysis

PD catheter placement with PEG tubes nephrostomy tubes ostomies

polycystic kidney disease peritoneal dialysis intra-abdominal pressure

calciphylaxis management in PD sodium thiosulfate and switch to HD