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Pediatric Kidney Transplant Rate Lower at For-Profit Dialysis Facilities

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Children receiving maintenance dialysis have lower rates of pediatric transplant waitlisting and kidney transplantation at facilities that are for-profit rather than nonprofit, according to an analysis of data from the US Renal Data System.

Among 13,333 pediatric patients with end-stage kidney disease (ESKD) who initiated dialysis during 2000-2018, 3618 (27%) attended for-profit facilities, 7907 (59%) attended nonprofit facilities, and 1748 (13%) switched profit status. Read more in Renal & Urology News.

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Kids Treated at For-Profit Dialysis Centers Less Likely to Receive Transplant

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— They also waited longer to be put on a waitlist

Children receiving dialysis at a for-profit facility were less likely to be put on the waitlist for — and ultimately receive — a kidney transplant, according to a retrospective cohort study.

Among over 13,000 pediatric patients, those receiving dialysis at a profit center had a 21% lower chance of being put on the waitlist for a kidney versus those receiving care at nonprofit facilities (adjusted HR 0.79, 95% CI 0.75-0.83), reported Sandra Amaral, MD, MHS, of the Children’s Hospital of Philadelphia, and colleagues.
Read the full story in MedPage Today.

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Patients who receive CKD education are likely to choose home dialysis at initiation

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Compared with patients who did not receive chronic kidney disease education, those who did were more likely to choose home dialysis and a permanent vascular access at initiation.

“Treatment options for kidney failure are complex, and the majority of patients who develop kidney failure lack important information about treatment options and are not prepared to make informed decisions about their care,” Katherine Mckeon, MSPH, from DaVita Clinical Research in Minnesota, and colleagues wrote.  Read more in Healio.

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Similar mortality for patients with COVID-19 on dialysis, kidney recipients with COVID-19

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Mortality among kidney transplant patients with COVID-19 and those on dialysis with COVID-19 was similar during the first and second waves of the pandemic in Europe.

“A number of studies compared mortality in the first and second waves among patients receiving kidney replacement therapy (KRT). These studies were hampered by the fact that they were single center by design and consequently had a small sample size,” Priya Vart, PhD, from the department internal medicine at the University Medical Center Groningen in The Netherlands, and colleagues wrote. “Furthermore, they lacked information on key patient and disease-related characteristics, including comorbidities, the reason for COVID-19 screening and disease symptoms.” Read more in Healio.

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Kidney Transplant Survival Benefit Greater for Patients on Dialysis

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Deceased donor kidney transplantation (DDKT) confers a greater survival benefit to adult waitlist candidates on dialysis than those managed preemptively, investigators reported at the 2022 American Transplant Congress (ATC 2022) in Boston, Massachusetts.

The current US Kidney Allocation System (KAS) allows for DDKT candidates not yet on dialysis to accrue waiting time points by listing at a transplant center with a low estimated glomerular filtration rate. Read the full story in Renal & Urology News.

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Racial disparities strongest among young adults on home dialysis, transplant recipients

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Racial and ethnic disparities in kidney replacement therapies were most pronounced among patients aged 22 to 44 years who are either transplant recipients or on home dialysis, according to data in the American Journal of Kidney Diseases.

“Research has shown wide racial and ethnic disparities in use of kidney transplant and home dialysis, yet how age interacts with these disparities is unknown,” Adam S. Wilk, PhD, and colleagues wrote. Read more in Healio.

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Treating Depression When You’re on Dialysis

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A recent study looked at how well two treatments for depression work for people on dialysis.

Depression is common in people who are on dialysis. Depression worsens your quality of life, makes you feel tired, and can affect your kidney health as well as your overall well-being.

There are many ways to treat depression, but not all ways work well for people who are on dialysis. Read the full story from Patient-Centered Outcomes Research Institute (PCORI).

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