My partners want to shift non-compliant HD patients to PD for better billing. I think non-compliant patients are safer in-center and possibly a harm to themselves at home. For example, IV drug users. Do other groups put IVDA on PD?

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Susan G, Doctor/MD from Roanoke, VA asked
My partners want to shift non-compliant HD patients to PD for better billing. I think non-compliant patients are safer in-center and possibly a harm to themselves at home. For example, IV drug users. Do other groups put IVDA on PD?

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Doctor (Canada) November 1, 2019

In general, decision making regarding choice of dialysis modality should not be based on billing, but rather based on patient preference and what is best for the patient. IV drug users are likely better off on PD rather than HD with a catheter as the tunneled line can be used for drug administration. Regarding compliance, I’m not sure that one modality would be better than another (eg. showing up for HD 1-2x/week vs. doing some but not all PD exchanges). If a PD patient is non-compliant, it will usually be apparent from their blood test results (and cycler digital card if they are on APD).

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