Home dialysis modalities are used in a minority of patients with kidney failure in the United States. During the 2018 National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) Home Dialysis Conference, numerous ideas were suggested to help minimize barriers for the uptake and retention of home dialysis therapies. First, educational tools are needed to increase knowledge about home dialysis modalities (eg, continuous ambulatory peritoneal dialysis, continuous cycling peritoneal dialysis, and home hemodialysis). Implementation of a hub and spoke model, pairing smaller and/or newer home dialysis programs with larger more sophisticated programs that offer education and mentoring, may help dialysis programs to grow and prosper. This pairing can be facilitated by traditional conferences and newer modalities such as telemedicine and training applications. Peer support to patients, such as that offered through the NKF Peers Program, and support and respite to care partners can have beneficial effects toward both increasing the number of patients who choose home dialysis as a modality and improving retention in home dialysis programs. Anticipating and understanding both patient and care partner burden is important for the development and implementation of patient- and care partner-centered support programs that can be deployed before a patient ceases home therapy. Finally, aligning Medicare reimbursement to support appropriate increased home dialysis uptake to prioritize both transplantation and home dialysis as the first-line treatments for kidney failure.

中文翻译：

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克服摄取和继续使用家庭透析的障碍：NKF-KDOQI会议报告。

在美国，少数肾衰竭患者使用家庭透析模式。在2018年美国肾脏基金会-肾脏疾病成果质量计划（NKF-KDOQI）家庭透析会议上，提出了许多想法来帮助最小化家庭透析疗法的吸收和保留障碍。首先，需要教育工具来增加有关家庭透析方式的知识（例如，连续非卧床腹膜透析，连续循环腹膜透析和家庭血液透析）。集线器和轮辐模型的实施，将较小和/或较新的家庭透析计划与提供教育和指导的较大的更复杂计划配对，可能有助于透析计划的发展和繁荣。可以通过传统会议和远程医疗和培训应用等更新方式来促进这种配对。对患者的同伴支持，例如通过NKF对等计划提供的支持，以及对护理合作伙伴的支持和喘息，既可以增加选择家庭透析作为治疗方式的患者数量，又可以改善对家庭透析计划的保留率。预见和理解患者和护理伙伴的负担对于开发和实施以患者和护理伙伴为中心的支持计划非常重要，该计划可以在患者停止家庭治疗之前进行部署。最后，调整Medicare报销以支持适当增加的家庭透析摄入量，以优先考虑移植和家庭透析作为肾脏衰竭的一线治疗方法。