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  1. Article ; Online: Kidney Failure in the Court of Chronic Diseases.

    Weinhandl, Eric D

    American journal of kidney diseases : the official journal of the National Kidney Foundation

    2023  Volume 83, Issue 1, Page(s) 6–8

    MeSH term(s) Humans ; Chronic Disease ; Renal Insufficiency
    Language English
    Publishing date 2023-11-11
    Publishing country United States
    Document type Editorial
    ZDB-ID 604539-x
    ISSN 1523-6838 ; 0272-6386
    ISSN (online) 1523-6838
    ISSN 0272-6386
    DOI 10.1053/j.ajkd.2023.08.006
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  2. Article ; Online: The coronavirus disease 2019 pandemic: the disruptor that maintenance dialysis never anticipated.

    Weinhandl, Eric D

    Current opinion in nephrology and hypertension

    2022  Volume 31, Issue 2, Page(s) 185–190

    Abstract: Purpose of review: The novel coronavirus 2019 (COVID-19) pandemic has upended maintenance dialysis in the United States. I review changes in prevalence, incidence, mortality, and other clinical outcomes among patients undergoing dialysis since March ... ...

    Abstract Purpose of review: The novel coronavirus 2019 (COVID-19) pandemic has upended maintenance dialysis in the United States. I review changes in prevalence, incidence, mortality, and other clinical outcomes among patients undergoing dialysis since March 2020, highlighting vulnerabilities in the current system and opportunities for improved care in the future.
    Recent findings: The number of dialysis patients in the United States declined between March 2020 and March 2021, an unprecedented year-over-year drop in the census. Some of the decline can be attributed to an early drop in patients initiating dialysis but most of the decline can be attributed to excess mortality. Kidney transplants also declined during the early part of the pandemic. Home dialysis utilization increased during 2020 but that increase was largely in line with secular trends. The rate of hospitalization for causes other than COVID-19 fell significantly during 2020.
    Summary: The epidemiology of dialysis in the United States is clearly modifiable, as it reflects decisions to initiate treatment, prescribe home therapies, and hospitalize patients with acute medical needs. On the other hand, some outcomes are powerfully guided by health outcomes in the general population, thus limiting the ability of dialysis providers and nephrologists to influence outcomes.
    MeSH term(s) COVID-19 ; Hemodialysis, Home ; Humans ; Pandemics ; Renal Dialysis/adverse effects ; SARS-CoV-2 ; United States/epidemiology
    Language English
    Publishing date 2022-01-27
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1151092-4
    ISSN 1473-6543 ; 1535-3842 ; 1062-4813 ; 1062-4821
    ISSN (online) 1473-6543 ; 1535-3842
    ISSN 1062-4813 ; 1062-4821
    DOI 10.1097/MNH.0000000000000777
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  3. Article ; Online: Economic Impact of Home Hemodialysis.

    Weinhandl, Eric D

    Advances in chronic kidney disease

    2021  Volume 28, Issue 2, Page(s) 136–142

    Abstract: Home hemodialysis (HD) is growing in the United States, but the economics of the modality are largely unknown, especially considering the unique aspects of home HD in the United States . In this review, I focus on details of Medicare coverage, which ... ...

    Abstract Home hemodialysis (HD) is growing in the United States, but the economics of the modality are largely unknown, especially considering the unique aspects of home HD in the United States . In this review, I focus on details of Medicare coverage, which directly applies to most patients on dialysis and influences the policies of private insurers. Key details in Medicare comprise the relationship between home dialysis training and initial Medicare eligibility, reimbursement for home HD training, coverage of additional HD treatments (ie., in excess of 3 treatments per week), and monthly capitated payments to nephrologists. The overarching narrative is that frequent home HD directly increases Medicare costs for outpatient dialysis, but these added costs can be mitigated by lower inpatient expenditures if increased HD treatment frequency lowers the risk of cardiovascular hospitalization and infection control is emphasized. I also review recent international literature; conventional home HD exhibits a superior cost profile, whereas frequent home HD is generally cost-effective over multiple treatment years (ie, if early technique failure is avoided). Out-of-pocket expenses for patients should be considered. The future economics of home HD in the United States will be determined by new equipment, new adaptations of the modality, and new payment models.
    MeSH term(s) Aged ; Cost-Benefit Analysis ; Hemodialysis, Home ; Humans ; Kidney Failure, Chronic/therapy ; Medicare ; Renal Dialysis ; United States
    Language English
    Publishing date 2021-10-27
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 1548-5609 ; 1548-5595
    ISSN (online) 1548-5609
    ISSN 1548-5595
    DOI 10.1053/j.ackd.2021.06.010
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  4. Article ; Online: From Home Dialysis Access to Home Dialysis Quality.

    Weinhandl, Eric D / Forfang, Derek

    Advances in chronic kidney disease

    2022  Volume 29, Issue 1, Page(s) 52–58

    Abstract: The number and percentage of patients dialyzing at home has steadily increased during the past decade, and federal policy initiatives have driven interest to a new high. However, the mere utilization of home dialysis does not ensure better outcomes for ... ...

    Abstract The number and percentage of patients dialyzing at home has steadily increased during the past decade, and federal policy initiatives have driven interest to a new high. However, the mere utilization of home dialysis does not ensure better outcomes for patients and care partners. Although public reporting systems for dialysis quality are mature and robust, the incorporation of home dialysis quality in those systems is immature; the advent of the End-Stage Renal Disease Treatment Choices payment model brings this problem into sharp relief. The home dialysis modalities present both common and unique targets for quality measurement. For both modalities, therapy duration (or its inverse, technique failure) is a potential target. For peritoneal dialysis, peritonitis, catheter complications, and residual kidney function are additional targets; for home hemodialysis, vascular access infections, dialysis adequacy, and treatment adherence are targets. Patient-reported experience measures are also important; this domain is a long-standing disparity, as in-facility hemodialysis patients have been routinely surveyed for several years. The statistical aspect of quality measurement in home dialysis requires some adaptation, as the typical home dialysis program is small, thus presenting a threat to reliability; pooling programs may be necessary. Ultimately, promoting high-quality home dialysis will likely increase utilization of home dialysis.
    MeSH term(s) Hemodialysis, Home/methods ; Humans ; Kidney Failure, Chronic/therapy ; Peritoneal Dialysis/methods ; Renal Dialysis/methods ; Reproducibility of Results
    Language English
    Publishing date 2022-06-09
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 1548-5609 ; 1548-5595
    ISSN (online) 1548-5609
    ISSN 1548-5595
    DOI 10.1053/j.ackd.2022.02.010
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  5. Article ; Online: Piecing Together the Risk of Sudden Cardiac Death on Dialysis.

    Weinhandl, Eric D

    Journal of the American Society of Nephrology : JASN

    2019  Volume 30, Issue 4, Page(s) 521–523

    MeSH term(s) Death, Sudden, Cardiac ; Electrocardiography ; Humans ; Maintenance ; Renal Dialysis ; Safety ; Serotonin Uptake Inhibitors
    Chemical Substances Serotonin Uptake Inhibitors
    Language English
    Publishing date 2019-03-18
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 1085942-1
    ISSN 1533-3450 ; 1046-6673
    ISSN (online) 1533-3450
    ISSN 1046-6673
    DOI 10.1681/ASN.2019020185
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  6. Article ; Online: Deprescribing the Kt/V Target for Peritoneal Dialysis in the United States: The Path Toward Adopting International Standards for Dialysis Adequacy.

    Maliha, George / Weinhandl, Eric D / Reddy, Yuvaram N V

    Journal of the American Society of Nephrology : JASN

    2023  Volume 34, Issue 5, Page(s) 751–754

    MeSH term(s) Humans ; United States ; Renal Dialysis ; Deprescriptions ; Peritoneal Dialysis ; Kidney Failure, Chronic
    Language English
    Publishing date 2023-02-14
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 1085942-1
    ISSN 1533-3450 ; 1046-6673
    ISSN (online) 1533-3450
    ISSN 1046-6673
    DOI 10.1681/ASN.0000000000000101
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  7. Article ; Online: Home-Based Dialysis: A Primer for the Internist.

    Rope, Robert / Ryan, Eric / Weinhandl, Eric D / Abra, Graham E

    Annual review of medicine

    2023  Volume 75, Page(s) 205–217

    Abstract: Home-based dialysis modalities offer both clinical and practical advantages to patients. The use of the home-based modalities, peritoneal dialysis and home hemodialysis, has been increasing over the past decade after a long period of decline. Given the ... ...

    Abstract Home-based dialysis modalities offer both clinical and practical advantages to patients. The use of the home-based modalities, peritoneal dialysis and home hemodialysis, has been increasing over the past decade after a long period of decline. Given the increasing frequency of use of these types of dialysis, it is important for clinicians to be familiar with how these types of dialysis are performed and key clinical aspects of care related to their use in patients with end-stage kidney disease.
    MeSH term(s) Humans ; Hemodialysis, Home ; Renal Dialysis ; Kidney Failure, Chronic/therapy
    Language English
    Publishing date 2023-12-01
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 207930-6
    ISSN 1545-326X ; 0066-4219
    ISSN (online) 1545-326X
    ISSN 0066-4219
    DOI 10.1146/annurev-med-050922-051415
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  8. Article ; Online: Pulling the goalie: What the United States and the world can learn from Canada about growing home dialysis.

    Abra, Graham / Weinhandl, Eric D

    Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis

    2021  Volume 41, Issue 5, Page(s) 437–440

    Language English
    Publishing date 2021-07-29
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 645010-6
    ISSN 1718-4304 ; 0896-8608
    ISSN (online) 1718-4304
    ISSN 0896-8608
    DOI 10.1177/08968608211034696
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  9. Article ; Online: Setting Up Home Dialysis Programs: Now and in the Future.

    Abra, Graham E / Weinhandl, Eric D / Hussein, Wael F

    Clinical journal of the American Society of Nephrology : CJASN

    2023  Volume 18, Issue 11, Page(s) 1490–1496

    Abstract: Home dialysis utilization has been growing in the United States over the past decade but still lags behind similar socioeconomic nations. More than half of dialysis facilities in the United States either are not licensed to offer home dialysis or, ... ...

    Abstract Home dialysis utilization has been growing in the United States over the past decade but still lags behind similar socioeconomic nations. More than half of dialysis facilities in the United States either are not licensed to offer home dialysis or, despite a license, have no patients dialyzing at home, and many programs have a relatively small census. Multiple stakeholders, including patients, health care providers, and payers, have identified increased home dialysis use as an important goal. To realize these goals, nephrologists and kidney care professionals need a sound understanding of the key considerations in home dialysis center operation. In this review, we outline the core domains required to set up and operate a home dialysis program in the United States now and in the future.
    MeSH term(s) Humans ; United States ; Hemodialysis, Home ; Kidney Failure, Chronic ; Health Facilities ; Nephrologists ; Motivation ; Renal Dialysis
    Language English
    Publishing date 2023-08-21
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 2226665-3
    ISSN 1555-905X ; 1555-9041
    ISSN (online) 1555-905X
    ISSN 1555-9041
    DOI 10.2215/CJN.0000000000000284
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  10. Article ; Online: Authors' Reply.

    Wetmore, James B / Johansen, Kirsten L / Weinhandl, Eric D

    Journal of the American Society of Nephrology : JASN

    2022  Volume 33, Issue 2, Page(s) 455–457

    Language English
    Publishing date 2022-01-28
    Publishing country United States
    Document type Letter ; Research Support, N.I.H., Extramural ; Comment
    ZDB-ID 1085942-1
    ISSN 1533-3450 ; 1046-6673
    ISSN (online) 1533-3450
    ISSN 1046-6673
    DOI 10.1681/ASN.2021111417
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