Broadening Access to Home Hemodialysis with VersiHD GuideMe Software

Introduction: Home hemodialysis (HHD) allows independence for patients with end stage kidney disease (ESKD) & is associated with improved patient satisfaction & clinical outcomes. In addition to bettering quality of life, HHD can improve blood pressure & fluid control. Despite proven benefits, the use of HHD remains limited due to the complexity of HHD training & concern for adverse events. The VersiHD GuideMe software aims to make HHD available to more patients by simplifying HHD. Case Description: Training for HHD takes 8-12 weeks, leading to significant time commitment for patients & care partners. We followed a patient training for HHD using the VersiHd GuideMe software. This software is available with the NxStage system & provides step-by-step instructions through a simplefied interface to improve ease & speed of learning for patients. Our patient suffered from chronic fluid overload & recurrent hospitalization while undergoing traditional, thrice weekly hemodialysis through an arteriovenous fistula. Using the VersiHD GuideMe software, the patient & their care partner were able to safely complete HHD training over a span of 3 weeks dating from 2/22/24-3/14/24. As of this writing, the patient has had no adverse events associated with HHD or new hospitalizations. This patient has had improved debilitation & is now undergoing transplant evaluation. Discussion: Despite improved clinical outcomes with HHD, utilization in practice has remained limited in part due to the technical complexity of treatment. Training for HHD can be a time-consuming process, with training taking 8-12 weeks. Using the VersiHD GuideMe software, our patient was able to complete HHD training in 3 weeks, resulting in an improvement in cardiovascular outcomes that were not achievable with traditional dialysis. The VersiHD GuideMe software provides a user-friendly, succinct method for training patients on HHD therapy, opening the door to more ESKD patients who can benefit from this therapy.