Fresenius Kidney Care, the dialysis services division of Fresenius Medical Care North America and provider of a network of dialysis facilities, intends to open more than 100 new transitional care units (TCUs) this year. These units will help people recently diagnosed with kidney failure learn about the treatment options available to them including home dialysis, and become more empowered in managing their own care.
 
TCUs are designed to be a separate space within a dialysis center with staff dedicated to onboarding patients new to dialysis during their first weeks of treatment, assisting patients transitioning between modalities, and supporting individuals returning to dialysis from transplant. This setting provides patients both the education and time to choose a therapy best suited for them, and greatly increases the chance that they will select a home therapy.
 
Fresenius Kidney Care has been rapidly opening TCUs, with a total of 65 operating already, in support of its home growth strategy. The company has found that over 50 percent of TCU patients will choose a home dialysis modality after completing this experience, compared to approximately 15 percent of new patients on average choosing home when they start dialysis.
 
"TCUs provide an incredible resource to help ensure that our patients have a smooth start to their dialysis treatment while aiming to reduce the risk of treatment gaps and hospitalization," said Joe Turk, President, Home and Critical Care Therapies, Fresenius Medical Care North America. "Best of all, TCUs help empower patients to make informed decisions about their therapy, while increasing the likelihood that they will take advantage of the many benefits that come with receiving their treatment at home."
 
People who are newly diagnosed with kidney failure can experience fear and anxiety as they adjust to life on dialysis, maintain safe levels of potassium and sodium, and control blood pressure.
 
The TCU offers comprehensive, hands-on education that is individualized for each patient. Patients have the opportunity to receive treatments with both in-center and home hemodialysis machines, consistent with their dialysis prescription, as well as familiarize themselves with peritoneal equipment and supplies. For those who ultimately choose in-center treatment, the TCU provides a more supportive way to begin dialysis, helping patients become more empowered and knowledgeable about their own care.
 
Many experts agree that home dialysis—either peritoneal or hemodialysis—is the best option aside from transplant for treating kidney failure. Choosing home dialysis can mean fewer food restrictions, greater scheduling flexibility, less frequent transportation challenges, and better outcomes.
 
"Home dialysis allows patients to receive life-sustaining treatment in the comfort of their homes, on a schedule that works best for their medical and lifestyle priorities," said Dr. Jeffrey Hymes, chief medical officer for Fresenius Kidney Care. "Patients in a TCU are able to receive one-on-one education and support on home dialysis in a low-risk environment so they can gain experience and confidence before dialyzing at home."
 
In July 2019, the U.S. Department of Health and Human Services launched the Advancing American Kidney Health Initiative which seeks to have 80 percent of newly diagnosed patients with kidney failure receive a transplant or home dialysis by 2025.
 
About 1 in 7 adults in the U.S. have chronic kidney disease (CKD), with many not detecting the condition until they have lost more than 96 percent of their kidney function. Symptoms and warning signs for late-stage kidney disease include changes in urination, fatigue, and swelling in hands or feet. Physicians recommend that people who are at risk for CKD are screened at least once a year.