During a recent panel discussion1 on advancing home dialysis, the moderator asked me to imagine what home dialysis might look like in 2030.

Instantly, I was transported to a future where home patients no longer lived their lives around dialysis treatments, with a constant focus instead on meeting their health care needs and simply living their lives.

I saw a future where care for home patients was transformed into a more pleasant consumer experience. As I answered the question – my mind already in 2030 – I spoke in reflection on how far we had come since 2021.

We arrived in this future state by creating a personalized care ecosystem, one that combines the technological advancements from the consumer space with insights gleaned from our home patients. It started by building on the care and data platforms already existing within our dialysis centers and adding intuitive technology-enabled solutions in the home.

Here are some specific examples.

Personalized home dialysis training: Virtual reality headsets allow for interactive, personalized patient training in the preferred language and at the reading level that works best for each patient – a far cry from sending patients home with paper handouts.

Automated patient support at home: In 2030, help is instantly available to home patients at the push of a button or through a simple voice command. The ability of the dialysis center to use augmented reality allows nurses, physicians and technicians to see what patients see as they troubleshoot and solve issues. This has helped address patient burnout and significantly reduced medical complications.

New modalities: The advent of wearable kidneys created a whole new home modality. Supported from the dialysis center in the same way home hemodialysis and peritoneal dialysis were in 2021, patients with “wearables” enjoy the freedom of being able to move through their day as they receive dialysis treatments.

Nutritional support: Leveraging the lab data from dialysis centers, along with dietician support, the standard home delivery of groceries that was commonplace in 2021 is seamlessly customized for a kidney-friendly diet in 2030. Patients no longer have to read every food label, which many patients did a decade ago.

Inventory control and connectivity: Radio-frequency identification for inventory control and management allows patients’ smart home dialysis technology to automatically communicate with their dialysis provider to help manage their home inventory. That, combined with internet-connected home dialysis machines, allows patients to easily track essential supplies and utilize automated ordering for their inventory needs.

Future bright is bright for patients living with kidney disease. The adoption of integrated and automated consumer technology with instant access to support services – all backed by dialysis centers and the expertise of care teams – allows home dialysis to become transparent in the lives of patients. These consumer-friendly advances have not only improved access to home dialysis but also patients’ quality of life and health outcomes.

As the session moderator advances the conversation, I am asked if all of this is possible possible by 2030, my answer is “yes.”

We already have efforts in the consumer technology space to reduce the digital divide: 5G connectivity, the “internet of things,” connected smart speakers at home and augmented reality and artificial intelligence. We also have passionate innovation on the part of dialysis providers, manufacturers, regulators, entrepreneurs and advocacy groups pushing to continuously improve the lives of patients with kidney disease.

The intersection of these two forces makes me optimistic we are taking the necessary steps toward this vision for the future.

1. Panel session II: Dialysis provider perspective – home dialysis. physicians IDEAS conference; Aug. 23, 2021 (virtual).

• For more information:
• Mahesh Krishnan, MD, MPH, MBA, FASN, is group vice president of research and development for DaVita Kidney Care and serves as the clinical lead for DaVita Venture Group. He can be reached at mahesh.krishnan@davita.com.