{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T11:52:50Z","timestamp":1778586770240,"version":"3.51.4"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T00:00:00Z","timestamp":1623801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Dialysis patients are often discharged from hospitals to skilled nursing facilities (SNFs), but little has been published about their natural history.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using electronic medical record data, we conducted a retrospective cohort study of nursing home patients treated with in\u2010SNF hemodialysis from January 1, 2018 through June 20, 2020 within a dialysis organization across eight states. A dialytic episode began with the first in\u2010SNF dialysis and was ended by hospitalization, death, transfer, or cessation of treatment. The clinical characteristics and natural history of these patients and their dialytic episodes are described.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Four thousand five hundred and ten patients experienced 9274 dialytic episodes. Dialytic episodes had a median duration of 18\u2009days (IQR: 8\u201338) and were terminated by a hospitalization <jats:italic>n<\/jats:italic>\u00a0=\u00a05747 (62%), transfer <jats:italic>n<\/jats:italic>\u00a0=\u00a02638 (28%), death <jats:italic>n<\/jats:italic>\u00a0=\u00a0568 (6%), dialysis withdrawal <jats:italic>n<\/jats:italic>\u00a0=\u00a0129 (1.4%), recovered function <jats:italic>n<\/jats:italic>\u00a0=\u00a02 (0.02%), or other cause <jats:italic>n<\/jats:italic>\u00a0=\u00a06 (0.06%). Increased patient mortality was associated with advancing age, low serum creatinine, albumin, or sodium, and low pre\u2010dialytic systolic blood pressure (sBP). U\u2010shaped relationships to mortality were observed for intradialytic hypotension frequency and for post\u2010\u2009&gt;\u2009pre\u2010hemodialysis sBP frequency. Prescription of dialysis five times weekly in the first 2\u2009weeks was associated with better survival in the first 90\u2009days (HR 0.77, CI 0.62\u20130.96; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Provision of in\u2010SNF dialysis by an external dialysis organization enables discharge from the acute care setting for appropriate treatment with increased nursing contact time in an otherwise under\u2010resourced environment. SNF ESRD patient clinical characteristics and outcomes are extensively characterized for the first time.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hdi.12943","type":"journal-article","created":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T07:37:13Z","timestamp":1623829033000},"page":"548-559","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Epidemiology of nursing home dialysis patients\u2014A hidden population"],"prefix":"10.1111","volume":"25","author":[{"given":"Eran Y.","family":"Bellin","sequence":"first","affiliation":[{"name":"Departments of Epidemiology &amp; Population Health and Medicine Albert Einstein College of Medicine  Bronx New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice M.","family":"Hellebrand","sequence":"additional","affiliation":[{"name":"Dialyze Direct  Neptune City New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven M.","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Dialyze Direct  Neptune City New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan G.","family":"Ledvina","sequence":"additional","affiliation":[{"name":"Dialyze Direct  Neptune City New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1157-3627","authenticated-orcid":false,"given":"William T.","family":"Markis","sequence":"additional","affiliation":[{"name":"WTM Consulting  Passaic New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan W.","family":"Levin","sequence":"additional","affiliation":[{"name":"Internal Medicine Mount Sinai Icahn School of Medicine  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allen M.","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Dialyze Direct  Neptune City New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,16]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"USRDSRenal data extraction and referencing (RenDER) system. 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