So, is this good news or bad news? While the number of dialysis patients is increasing, the rate of annual increase has lessened. Back in 2016, there were 20K new patients, it dropped again last year, and this year the total increase was closer to 14K.

I choose to believe that the rate of increase is dropping because we found better ways to keep pre-dialysis clinical situations under control. (As opposed to preventing those patients who need dialysis from getting the procedure.)

But, the best news of all is that more and more patients are being dialyzed at home- they are not traveling to and from a clinical center. About 1/3 of all new patients were on home dialysis (either PD [peritoneal dialysis] or HD [hemodialysis; when this is done at home it is termed HHD]), which is up from 15% last year and almost triple the number for 2016. The growth in HHD approached 1000 patients, with PD obtaining the bulk of home dialysis patients at more than 4000.

Obviously, the dialysis providers are going to have to do better if we plan to meet TheDonald’s goals. As stated previously, the goal is that 80% of all ESRD (End Stage Renal Disease) patients will be treated at home or have undergone a transplant.

One of the biggest impediments is the regulations.  Right now, peritoneal dialysis is easily dealt with because physicians can monitor their patients remotely (telehealth, telemedicine).  That sort of monitoring can’t really be done for home hemodialysis because there are regulations that vascular access (required to connect up the extracorporeal blood circuit) must be examined in person by a medical professional.  (This is still the regulation, despite the fact the patency of vascular accesses can be monitored via ultrasound [auscultation]).

Hopefully, that will change soon.

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