Bringing Dialysis Home Reels

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The Problem with In-Center Dialysis

For decades, in-center dialysis has been the default treatment for kidney failure. But is it the best option? We discuss the limitations of traditional dialysis—its timeconsuming nature, health risks, and negative impact on quality of life—while shedding light on why home dialysis remains underutilized.

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The Government s Push for Home Dialysis

A major policy shift began in 2019 with the Executive Order on Advancing American Kidney Health. This initiative set the ambitious goal of ensuring 80% of new kidney failure patients receive either a transplant or home dialysis by 2025. Tune in to learn how this order is reshaping kidney care.

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Medicare, Telemedicine, and the Policy Shift

The healthcare system is finally catching up. With Medicare s new incentives and telemedicine reforms, home dialysis is more accessible than ever. We break down the recent policy changes that are making it easier for patients to receive treatment from the comfort of their homes.

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Technology is Changing Home Dialysis

Today’s dialysis machines are smaller, smarter, and more user-friendly than ever before. From portable devices to remote monitoring, we explore the technological advancements that are eliminating previous barriers and making home dialysis a viable option for more patients.

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Insurance is Catching Up—What It Means for You

Home dialysis is becoming more financially feasible. In this episode, we discuss how Medicare and private insurers are expanding coverage, increasing reimbursements, and introducing new flexibility in employer-sponsored plans. Find out what this means for your treatment options.

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The Role of Staff-Assisted Home Dialysis

While home dialysis offers freedom, managing treatments alone can be overwhelming. That s where staff-assisted home dialysis comes in. We discuss how trained professionals can support patients in their homes, making treatments easier, safer, and more effective.

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The Best of Both Worlds Flexibility & Support

No more struggling with setup or missing treatments due to caregiver burnout. In this episode, we highlight how staffassisted home dialysis combines the independence of home treatment with the expertise of healthcare professionals, giving patients peace of mind.

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Advocacy, Education, and the Road Ahead

Despite progress, challenges remain. Not all nephrologists are trained in home dialysis, financial incentives still favor in-center care, and many patients don t know their options. Change starts with awareness. Join us as we discuss how advocacy, education, and action can make home dialysis the standard not the exception.

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The Power of Your Plate

What if your dinner plate was actually a powerful tool for kidney health? Learn how diet changes can make all the difference for those with kidney disease.

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Understanding Your Kidneys

Your kidneys are your body’s natural filtration system! Discover why diet matters so much when these vital organs aren’t functioning at their best.

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The Kidney-Friendly Food Guide

From colorful bell peppers to lean proteins – discover the foods that support kidney function and may help slow disease progression. Your kidney-friendly shopping list starts here!

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Foods That Harm Your Kidneys

These common foods could be silently damaging your kidneys. Learn which high-sodium, high-potassium, and phosphorus-rich foods to avoid when managing kidney disease.

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Personalized Kidney Nutrition

Not all kidney diets are created equal! Learn how dietary needs change with different stages of kidney disease and why personalized nutrition matters.

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Simple Steps for Kidney-Friendly Eating

Overwhelmed by dietary changes? These simple strategies make kidney-friendly eating manageable and sustainable. Small changes, big impact.

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Taking Control of Your Health

The right food choices empower you in your kidney health journey. Remember to share this vital information with others who might benefit! (Always consult healthcare providers before making dietary changes.)

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Grow Your Home Dialysis Program with Confidence

Ready to scale your home dialysis program with real, measurable results? At Local Home Hemo, we partner with providers who are serious about patient success and long-term program growth. Our innovative, staff-assisted approach is built to support patients and boost retention—because starting a program is one thing, but keeping it thriving is what sets you apart.

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Innovation Challenges in Nephrology

Dr. Qasim discusses the historical lack of innovation in nephrology during his 15-year career, noting how the 2019 Executive Order on Advancing American Kidney Health helped jumpstart progress. He highlights recent pharmaceutical advancements like SGLT2 inhibitors and GLP-1 agonists, along with improvements in dialysis machine interfaces and healthcare policies.

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Home Dialysis Adoption Goals

A focused discussion on the ambitious goal of having 80% of new ESRD patients treated at home or receiving transplants. Dr. Kassam shares his perspective that while the target may seem unattainable, setting high benchmarks drives meaningful progress. He explains how nephrologists’ analytical nature tends to make them slower adopters of new technologies compared to other medical specialties.

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Accelerating Innovation Adoption in Nephrology

Our team member asks for strategies to encourage faster adoption of innovations among nephrologists. Dr. Qasim suggests monetary incentives like the transplant bonus ($15,000 to physician practices) and integrating value-based care principles into fellowship training programs, including optimal dialysis start, home dialysis encouragement, and appropriate medication protocols.

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Future Technological Changes in Nephrology

The conversation shifts to necessary changes in nephrology over the next five years, with Dr. Qasim emphasizing the importance of integrating artificial intelligence as “augmented intelligence” to enhance patient care. He explains how AI applications can help identify patients at risk for CKD progression earlier and identify better candidates for home dialysis.

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Home Dialysis Patient Selection

Dr. Qasim shares his philosophy that clinicians should assume all patients are candidates for home dialysis until proven otherwise, similar to the “fistula first” approach. He discusses his detailed patient assessment process covering home situations, pets, family support, and insurance coverage, noting that only specific circumstances like housing instability or cognitive limitations should exclude patients from home options.

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Effective Home Dialysis Advocacy

The final segment explores Dr. Qasim approach to advocating for home dialysis, where he emphasizes the importance of being a “salesman” for home treatment options. He describes how he addresses patients’ common fears about being alone during home treatments by highlighting 24/7 nursing support, the benefits of daily dialysis, and fewer dietary restrictions compared to in-center treatment.

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Challenges of Home Dialysis – Focus on Hemodialysis

A discussion about the challenges patients face with home hemodialysis, particularly self-cannulation (inserting needles) and care partner burnout. The nephrologist shares experiences from previous practice, noting psychological hurdles for patients self-cannulating and potential relationship strain when partners assist. Suggests implementing periodic “home holidays” where patients temporarily return to in-center dialysis to prevent burnout.

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Staff-Assisted Home Hemodialysis Inquiry

Brief exchange about staff-assisted home hemodialysis, where professional nurses would handle dialysis administration in patients’ homes. The nephrologist has limited experience with this model and notes potential insurance coverage challenges, while the interviewer mentions their company’s commitment to expanding this option.

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Comparing Peritoneal Dialysis and Home Hemodialysis

Discussion about why peritoneal dialysis (PD) is more common than home hemodialysis. The nephrologist explains personal preference for starting patients on PD to preserve arm vasculature for potential future access needs. Key barriers to home hemodialysis adoption include the psychological hurdle of self-cannulation and aesthetic concerns about fistulas, while noting how provider biases might influence treatment recommendations.

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Reducing Barriers to Home Dialysis Access

Conversation about potentially using intravenous catheters for home hemodialysis to reduce access barriers. The nephrologist discusses the evolution from “fistula first” to “catheter last” approaches and advocates for individualizing treatment based on patient age and needs. Notes that long-term catheter use impacts dialysis center quality metrics but may be appropriate for elderly patients with shorter life expectancies.

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Supporting Nephrologists in Industry Partnerships

Brief discussion about how companies can better support nephrologists. The key recommendation is ongoing engagement beyond the initial sale, including thorough implementation support and regular follow-up. Emphasizes the importance of “handholding” during early adoption phases to ensure successful integration into clinical workflows and focus on customer retention.

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Benefits of Peritoneal Dialysis vs. Home Hemodialysis

Discussion comparing peritoneal dialysis (PD) benefits over home hemodialysis, highlighting three key advantages: avoiding self-cannulation challenges, preserving arm vasculature, and providing more gentle treatment that helps maintain residual kidney function. The nephrologist emphasizes how PD patients often continue urinating, which is beneficial since kidneys perform multiple important functions. 

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Closing Conversation and Future Collaboration

Brief closing remarks where the interviewer thanks the nephrologist for sharing perspectives on patient care. The nephrologist inquires whether the company offers peritoneal dialysis services. The interviewer explains they currently focus on home hemodialysis but notes growing interest in peritoneal dialysis services based on consistent feedback from physicians and patients.

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Potential for Staff-Assisted Peritoneal Dialysis

Discussion about how professional nurses might support peritoneal dialysis patients who have physical limitations (dexterity issues, arthritis, vision problems) but could manage with setup assistance. The nephrologist provides candid feedback that staff-assisted home dialysis is a “niche of a niche” with limited insurance coverage and suggests broadening services beyond just home hemodialysis to increase referral opportunities from nephrologists.

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Business Model and Value-Based Care Opportunities

Conversation about the business viability of staff-assisted dialysis services. The interviewer explains that while the market is limited, profit margins are substantial, and there’s opportunity within value-based care models due to potential reduction in re-hospitalization rates. They discuss partnerships with value-based care providers who are excited about the benefits of having nurses provide in-home monitoring. The interviewer emphasizes their company serves as a complementary “bolt-on solution” rather than competing with kidney centers.