Washington, DC (April 28, 2025) — The American Society of Nephrology (ASN) is designing a pilot Centers of Excellence in Home Dialysis program intended to recognize health care organizations that meet or exceed national standards and evidence-based guidelines in the care and treatment of people on home dialysis. The program’s goal is to enhance patient outcomes while increasing access to home modalities and strengthening the infrastructure of home dialysis programs in North America.
Program development will begin in Spring of 2025.
In 2019, the executive order set a goal to improve access to and quality of person-centered treatment options. When the Medicare End-Stage Renal Disease (ESRD) Program started in 1973, “more than 40% of the 11,000 or so [patients on dialysis] in the United States” were receiving “home hemodialysis” (). By the time of the executive order in 2019, the total number of patients on dialysis in the United States had increased to 566,614, but the percentage dialyzing at home was only 13.1% (). Today, we estimate the number of people dialyzing at home at around 14.5% ().
“Although uptake of home dialysis has increased slightly in recent years, barriers such as fear of dialyzing at home, lack of awareness of treatment options, lack of infrastructure, and workforce training and shortages within the local health care system remain.”, said Edward Gould, MD, FASN, co-Chair ASN Home Dialysis Steering Committee and Chair of the Centers for Excellence in Home Dialysis Workgroup.
In July 2021, ASN formed a Home Dialysis Steering Committee to identify and prioritize gaps in training, education, and advocacy in home dialysis. The Committee conducted a survey of nephrology program directors and division chiefs in the United States. Of those individuals surveyed, 72% believed every graduate of their fellowship program could provide peritoneal dialysis without supervision, and only 30% felt graduating fellows could provide home hemodialysis without supervision ().
Centers of excellence programs distinguish institutions for their expertise in treatment of medical conditions. They have the ability to improve outcomes through enhanced quality care, staff recruitment and retention, and to increase efficiencies within health care systems. Additionally, designated centers can serve as a resource, providing expertise to other programs striving for excellence.
“Through this ASN program, designated facilities can serve as a model for home dialysis care and demonstrate their commitment to ensuring choice of modality treatment for all people with kidney diseases, said Dr. Gould. “By setting criteria for programs to be considered excellent, clinicians and organizations can strive for excellence and those with the award can become recognized as regional leaders in home dialysis, serving as a resource to other home dialysis clinicians and programs.”
About ASN
Since 1966, ASN has been leading the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge and advocating for the highest quality care for patients. ASN has nearly 22,000 members representing 141 countries. For more information, visit and follow us on , , , , , and .
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Support for the Centers of Excellence in Home Dialysis program is provided by Vantive.
- Blagg CR. A brief history of home hemodialysis. Adv Ren Replace Ther. Apr 1996;3(2):99-105. doi:10.1016/s1073-4449(96)80048-3
- United States Renal Data System. 2021 USRDS Annual Data Report: Epidemiology of kidney disease in the United States. 2021. https://adr.usrds.org/2021
- United States Renal Data System. 2024 USRDS Annual Data Report: Epidemiology of kidney disease in the United States. 2024.
- Reddy YNV, Berns JS, Bansal S, et al. Home Dialysis Training Needs for Fellows: A Survey of Nephrology Program Directors and Division Chiefs in the United States. Kidney Med. May 2023;5(5):100629. doi:10.1016/j.xkme.2023.100629
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