ASN and Home Dialysis University Extend Partnership in 2024

Home dialysis has been associated with lower cost and equal or better clinical outcomes than facility-based dialysis (1). However, in 2021, only 14.1% of Medicare patients receiving dialysis underwent home dialysis, according to data from the National Institute of Diabetes and Digestive and Kidney Diseases (2). Additionally, despite a higher incidence and prevalence of kidney diseases among Black and Hispanic individuals, they are less likely to be treated with home dialysis when compared with non-Hispanic White individuals (3).

In July 2021, ASN formed a Home Dialysis Steering Committee to identify and prioritize gaps in training, education, and advocacy in home dialysis. Recommendations from the Steering Committee led to a collaboration between ASN and the Home Dialysis University (HDU) to boost nephrology trainees’ knowledge and familiarity with home dialysis therapies. The agreement provided 30 nephrology fellows scholarships to attend a 2-day HDU training course plus participate in a virtual education series over the past year. It has proven so successful that ASN is extending the program, offering scholarships to 45 fellows in 2024.

“It's going great—the fellows are really engaged,” said Jeffrey Perl, MD, FRCP, a co-chair of ASN's Home Dialysis Task Force and a staff nephrologist at St. Michael's Hospital in Toronto. “What we really want is for fellows who complete the program to feel that they’re part of a home dialysis community and can continue to rely on the faculty and moderators for ongoing support around any home dialysis issues that they encounter in the future.”

The program highlights ASN's commitment to improving education of home dialysis so that all patients in need of dialysis can have home dialysis as a possible treatment option, Perl explained. It will continue to evolve, he said, and seeks applicants from across the United States.

Fatima Ayub, MD, who will soon start as a faculty member with the University of Arkansas for Medical Sciences and the Central Arkansas Veterans Healthcare System in Little Rock, said that attending the HDU had been on her radar since a colleague recommended it, but receiving a scholarship last year was “the cherry on top.”

As a busy mother of 2-year-old twins, Ayub said she does not have a lot of time for reading and studying at home. Preparing for the virtual sessions by reading about interesting cases and participating in them has helped reinforce information about home dialysis that she has taken with her into the clinic setting. “It's fabulous—I don't have enough words to describe it,” Ayub said of the program, noting that it has helped clear up a lot of concepts for her regarding home dialysis and enabled her to feel more confident while managing patients. She is now routinely seeing patients in home therapy clinics and implementing the knowledge that she received from HDU faculty.

“Faculty members are extremely knowledgeable and easily accessible,” she added. “They would answer and reply to even very basic questions and explain things in a way that would inspire the fellows and make difficult topics really interesting.”

Ayub highly recommended that other fellows apply for the program. “It's a great opportunity—there are some topics that are covered in this fellowship program that you will never get the chance to read about again,” she said. “Nephrology is a vast field, and in 2 years [of fellowship], there's only so much that you can do, especially when you’re busy with inpatient and outpatient rotations and in dialysis units.”

The scholarship covers attendance at an HDU course (September 8–10, 2024, in Chicago, IL), and participation in a virtual case-based education series to be held between August 2024 and June 2025. Virtual series sessions have covered a wide range of topics in home hemodialysis and home peritoneal dialysis, including dialysis access, complications’ management, writing prescriptions, as well as day-to-day troubleshooting, described Christopher Chan, MD, FRCPC, a clinician investigator with the Toronto General Hospital Research Institute, who is a moderator of the virtual series.

“The intent of the virtual curriculum is to create a wealth of knowledge for people practicing home dialysis, much like a mini fellowship,” Chan said. “There has been a really consistent and favorable uptake by all the fellows. People are quite open to asking questions and verifying and clarifying the content,” he added. “There are lots of resources available, and I hope that this also will be an important resource for physicians who are dedicating their career to home dialysis.”

“Funding for the scholarship opportunity stemmed from a cooperative agreement between ASN and the Centers for Disease Control and Prevention (CDC) to enable nephrology fellows to receive training in home hemodialysis and home peritoneal dialysis from respected leaders,” Perl said. “As such, an important focus of the program is understanding best practices for prevention and management of infections for patients undergoing peritoneal dialysis. Infection is the leading cause behind why patients undergoing peritoneal dialysis have to transfer to hemodialysis,” he said.

Eligible applicants for the scholarship must be second- or third-year nephrology fellows in an Accreditation Council for Graduate Medical Education-accredited training program, never have attended an HDU course, and have support from their training program director to attend the course and participate in the longitudinal virtual education program. They can have any level of prior experience with home dialysis.

Fellows selected for the program receive meeting costs of up to $1500 to cover HDU registration, two hotel nights, meals during the meeting, and reimbursed travel costs of up to $300. For more information, or to apply, visit the Home Dialysis Scholarship Program webpage: https://epc.asn-online.org/projects/hdp/home-dialysis-scholarship-program/#gsc.tab=0. The application is open through May 31, 2024, and notification of decisions will be sent in June. Fellows who are not awarded a scholarship for the virtual curriculum are still welcome to attend an in-person HDU training course, Perl said.

Visit the HDU website for more information on the program: https://3eaglesinc.com/hduforfellows/.