Needs and Considerations for Standardization of Kidney Disease Education in Patients with Advanced CKD

Abstract

Kidney health advocacy organizations and leaders in the nephrology community have repeatedly emphasized the need to increase home dialysis utilization in the United States. Limited awareness and understanding of options for the management of kidney failure among patients living with advanced CKD is a significant barrier to increasing the selection and use of home dialysis. Studies have shown that providing targeted comprehensive patient education before the onset of kidney failure can improve patients' awareness of kidney disease and substantially increase the informed utilization of home dialysis. Unfortunately, in the absence of validated evidence-based education protocols, outcomes associated with home dialysis use vary widely among published studies, potentially affecting the routine implementation and reporting of these services among patients with advanced CKD. This review provides pragmatic guidance on establishing effective patient-centered education programs to empower patients to make informed decisions about their KRT and, in turn, increase home dialysis use.

Figure 1

Home dialysis selection and utilization rates among the published reports of CoPE. Home KRT includes the home peritoneal dialysis and home hemodialysis with a fraction of self-care dialysis in isolated studies. Each bar represents a separate publication/year.^{,,–,–,–} *Study was a randomized trial comparing between the two different types of education; **the upper and lower limit of prevalent national dialysis rates were established by examining the United States Renal Data System–reported rates of home dialysis for the respective country of publication, for the publication year±1 year. CoPE, Comprehensive Pre-kidney failure Education.