U.S. Rep. Bobby Rush

U.S. Rep. Bobby Rush

Expand access to home dialysis, Rush says

From staff reports

Legislation to expand access to home dialysis for kidney patients was recently introduced by U.S. Reps. Bobby L. Rush (D-1st) and Jason Smith, a Republican from Missouri.

Home dialysis often leads to better health outcomes and fewer hospitalizations for kidney patients; it is also far more flexible than in-center dialysis, making it easier for dialysis patients to maintain employment.

The Improving Access to Home Dialysis Act would provide Medicare reimbursement for trained, professional staff to visit home dialysis patients and assist them with their home dialysis treatments.

BobbyRush

U.S. Rep. Bobby Rush (D-1st)

The legislation is designed to ensure that all kidney patients are educated about home dialysis options early in their treatment process and given the support they need to utilize home dialysis, should they choose to do so.

It also would require the U.S Department of Health and Human Services to conduct a study on racial disparities in the utilization of home dialysis and provide concrete data on outcomes for in-center and home dialysis patients.

Rush said a 2016 study found that compared to white Americans, black Americans were 60% less likely to be treated with home hemodialysis and 47% less likely to be treated with peritoneal dialysis at home.

“Home dialysis is a better treatment option than in-center dialysis for many kidney patients — it is far more flexible and can lead to better health outcomes and quality of life,” Rush said. “However, I am concerned by data showing that black Americans are significantly less likely to be treated with home dialysis than their white counterparts.

“While I am grateful that my constituents are able to rely on dialysis centers in their time of need, I have long worried about the proliferation of dialysis centers in poorer and minority neighborhoods,” the congressman added. “We must do more to ensure that all kidney patients are able to access the full range of treatment options.”

More than 750,000 adults in the United States have irreversible kidney failure and require either a transplant or multiple dialysis treatments per week to survive. The vast majority (85%) of the 550,000 kidney patients receiving dialysis in the U.S. travel to dialysis centers for treatment, which takes place multiple times a week for up to four hours per session.

This schedule makes it difficult for kidney patients to hold down employment, and many face transportation barriers getting to and from dialysis centers.

A recent study found that patients dialyzing in a facility were two to three times more likely to contract COVID-19 and the U.S. Renal Data System estimated that patients who received dialysis treatments in a facility were up to four times more likely to be hospitalized for COVID-19 than patients who dialyzed at home.

Dialyzing at home means a patient can do more frequent but shorter dialysis sessions, which can lead to better health outcomes and fewer hospitalizations. Due to the increased flexibility of a home dialysis schedule, home dialysis patients are also more likely to maintain employment. Studies have also indicated that home dialysis could result in cost savings, as home dialysis patients have fewer complications and hospitalizations than in-center patients.

The Improving Access to Home Dialysis Act is widely supported by the kidney community, including the National Kidney Foundation, the American Society of Nephrology, and Home Dialyzors United (HDU). Here is what they had to say about the legislation:

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