Abstract

Background: Home hemodialysis is a growing treatment modality for end-stage renal disease. Home hemodialysis facilitates increased treatment frequency, which may reduce intradialytic symptoms, decrease risk of cardiovascular morbidity, and improve quality of life. However, patients may elect to discontinue home hemodialysis for medical or psychosocial reasons and to convert to in-center hemodialysis. Tools that improve communication and coordination between patients and providers and reduce therapy burden on patients may reduce risk of attrition. Nx2me Connected Health (NxStage Medical, Inc, Lawrence, MA) is a telehealth platform that collects NxStage System One cycler data and patient factors (eg, blood pressure, weight), transmits data to providers after each dialysis session, and enables providers to review data in the Nx2me Clinician Portal regularly; in contrast, usual care involves monthly review of patient-completed session records on paper.

Highlights

  • Home hemodialysis is a growing treatment modality for end-stage renal disease

  • To assess whether use of Nx2me Connected Health was associated with reduced risk of home hemodialysis attrition in patients on the System One cycler

  • For a Nx2me user who had accumulated t days with the System One cycler at first use of Nx2me, we identified potential controls who had accumulated at least t days with the System One cycler and retained those in the same treatment setting as the Nx2me user at t days after first use of the System One cycler

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Summary

Introduction

Home hemodialysis is a growing treatment modality for end-stage renal disease. Home hemodialysis facilitates increased treatment frequency, which may reduce intradialytic symptoms, decrease risk of cardiovascular morbidity, and improve quality of life. Patients may elect to discontinue home hemodialysis for medical or psychosocial reasons and to convert to in-center hemodialysis. Tools that improve communication and coordination between patients and providers and reduce therapy burden on patients may reduce risk of attrition. Nx2me Connected Health (NxStage Medical, Inc, Lawrence, MA) is a telehealth platform that collects NxStage System One cycler data and patient factors (eg, blood pressure, weight), transmits data to providers after each dialysis session, and enables providers to review data in the Nx2me Clinician Portal regularly; in contrast, usual care involves monthly review of patient-completed session records on paper

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