A bipartisan bill has recently been introduced to the US House of Representatives by Representatives Carol Miller (R-WV), Marilyn Strickland (D-WA), Earl Blumenauer (D-OR), and Mariannette Miller-Meeks (R-IA)—with a companion bill expected to be introduced soon in the Senate. The Improving Access to Home Dialysis Act (HR-8075) aims to increase access to care and improve outcomes for patients on dialysis, which has garnered support from the National Kidney Foundation (NKF).
One thing that this could do, the NKF suggests via a press release, is increase access to home dialysis. Whilst the foundation acknowledges that home dialysis is not for everyone, it states that it can provide patients with convenient and flexible alternatives to in-hospital treatment options, which allow them to undergo dialysis in their own homes, without a rigid dialysis schedule set for them.
The NKF adds that this option can be particularly useful to patients in rural or remote areas, by removing the need to travel long distances in order to attend appointments at a dialysis facility. It states that this can “greatly improve the quality of life for patients”, which can lead to patients being more likely to maintain employment and a level of health for long enough to qualify for a kidney transplant.
Despite the benefits of home dialysis, the NKF states that only 14% of patients on dialysis in the USA are using at-home options, despite the availability of evidence that demonstrates that it may be a better option for some patients. The foundation opines that a lack of information is a major barrier, as many patients are not able to educate themselves on the options available to them beyond the traditional in-centre care.
Commenting on the new bills’ introduction to the US House of Representatives, Kevin Longino, chief executive officer (CEO) of the NKF and a recipient of a kidney transplant, said: “Patients deserve to know about all options for dialysis so they can make an educated choice for themselves. Too many patients are never told they have options, besides in-centre dialysis, that could improve their quality of life. We are deeply appreciative of Representatives Miller, Strickland, Blumenauer, and Miller-Meeks for their introduction of The Improving Access to Home Dialysis Act, which will help more patients learn about and gain access to home dialysis.”
The Improving Access to Home Dialysis Act will, if passed, do the following: mandate that patients get proper education on all of their dialysis options, including making sure that even patients who crash onto dialysis with no preparation can get education on other options once they have stabilised and can make informed decisions about their future; expand the universe of healthcare providers who can provide home dialysis training to remove the burden from the nursing staff and cut down on wait times to get trained, as well as also allowing for the use of group training, telehealth, and off-site training when appropriate; cover the costs of in-home healthcare support staff for patients when they’re beginning their home dialysis journey, which would help patients transition from the facility and support the patient and if available, their care partner, with the goal that they become fully independent over time. Some patients with certain disabilities or other concerns could be eligible for continuing in-home assistance.
The NKF also highlighted patients and advocates who have been able to utilise home dialysis in the past are also voicing their support in its press release. Erich Ditschman, an NKF volunteer from East Lansing, USA, stated: “In 2001, I was fortunate to be offered home haemodialysis soon after I crashed into end-stage kidney disease [ESKD]. Home dialysis gives me the energy and health to be a better husband, father, and friend. Many of the patients on in-centre dialysis may not know home dialysis exists or have not been given the opportunity to use it. Once passed and signed, this legislation will help to make home dialysis much more accessible, especially to rural patients. It will save lives and help many ESKD patients to flourish.”
Bell Maddux, an NKF advocate from New York, USA, also commented, saying: “I am grateful to Representatives Miller, Strickland, Blumenauer, and Miller-Meeks for spearheading this push to make home dialysis more accessible for us. Policies like this make me increasingly optimistic that more kidney patients struggling with dialysis can have a chance to get some of their life back.”
Speaking in support of the bill that she co-sponsored, Congresswoman Marilyn Strickland from Olympia, USA, averred that “high-quality and affordable kidney care should not be considered a luxury in the USA. We must work together with caregivers and providers to ensure that patients have the resources and training they need to receive dialysis in the comfort of their own homes, and make sure that patients know that in-home care is an option.” Her colleague and fellow co-sponsor, Congresswoman Carol Miller from Huntington, USA, also commented on the bill, stating: “Individuals with [ESKD] are often faced with difficult decisions when choosing where to receive dialysis services. In rural areas, some patients must forgo a full-time job or time with their family to travel hours back and forth to dialysis centres to receive the life-sustaining care they need. Home dialysis is a wonderful tool that allows patients to be at the centre of their own care, and Congress should be working to ensure patients that choose this modality receive the training necessary to dialyse safely in their home. The Improving Access to Home Dialysis Act will provide patients the education and support they need to utilise home dialysis if they so choose.”
