Seasonal Differences in Home Dialysis Uptake and Initiating Dialysis in the Hospital

University of Southern California400,000 enrolled

Overview

This study will investigate whether home dialysis uptake varies by the season of year. We will also investigate whether hospitalizations around the time of dialysis also vary by season of year and whether hospitalizations are associated with reduced home dialysis starts and sustained home dialysis uptake.

Study Type

OBSERVATIONAL

Enrollment

400,000

Conditions

Dialysis Peritoneal Dialysis Hospitalizations

Interventions

Season of YearOTHER

We stratify patients into 4 groups based on the season of the year (between 12/1/2007-11/30/2017) * Winter: December, January, February * Spring: March, April, May * Summer: June, July, August * Fall: September, October, November

Hospitalized 14 days prior to dialysisOTHER

We further stratify patients into 3 groups based on whether they were hospitalized within 14 days prior to dialysis * Group 1: No hospitalization prior to dialysis * Group 2: Hospitalized within 14 days prior to dialysis for an acute infectious respiratory condition or one of the following acute cardiac conditions (arrhythmia, myocardial infarction, stroke, or fluid overload) * Group 3: Hospitalized within 14 days prior to dialysis for a condition not in Group 2

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Started dialysis in the USA for end-stage kidney disease from 12/1/2007-11/30/2017 * No transplant or death prior to day 90 of dialysis * Medicare Parts A/B as primary payer 30 days prior to starting dialysis * Valid Medicare Evidence Form (Form 2728) Exclusion Criteria: * As above

Outcomes

Primary Outcomes

Type of dialysis modality at the start of dialysis

Whether patient started with home dialysis or in-center dialysis at the start of dialysis

Time frame: Day 1 of dialysis

Type of dialysis modality at the end of month 3 of dialysis

Whether patient was using home dialysis or in-center dialysis at the end of month 3 of dialysis (day 84)

Time frame: End of month 3 of dialysis

Type of dialysis modality at the end of month 6 of dialysis

Whether patient was using home dialysis or in-center dialysis at the end of month 6 of dialysis (day 168)

Time frame: End of month 6 of dialysis

Type of dialysis modality at the end of month 9 of dialysis

Whether patient was using home dialysis or in-center dialysis at the end of month 9 of dialysis (day 252)

Time frame: End of month 9 of dialysis

Type of dialysis modality at the end of month 12 of dialysis

Whether patient was using home dialysis or in-center dialysis at the end of month 12 of dialysis (day 336)

Time frame: End of month 12 of dialysis

Mortality in the first year

Whether the patient died in the first year of dialysis and the number of days the patient survived \- Censored for transplantation, loss to follow-up

Time frame: 1 year of dialysis

Data from ClinicalTrials.gov

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