One Million Acute Insourced Dialysis Treatments Using Newer Technology

Background: Acute dialysis delivery is associated with significantly high cost of care. Reports on insourcing dialysis with newer technology have shown reduced cost, improved efficiency and similar, if not improved, outcomes. The Tablo® Hemodialysis System (Tablo) enables insourcing dialysis through its ease of use, integrated water purification, treatment flexibility (≤ 24 hours) and wireless data transmission. Methods: Transmitted data from Tablo’s cloud-based platform was filtered for acute treatments. Analysis included prescribed and achieved time and ultrafiltration (UF), alarms, and alarm resolution time. Treatments were grouped based on prescribed time: intermittent hemodialysis (IHD) and prolonged intermittent kidney replacement (PIKRT). Results were categorized as achieving the prescribed time within 5 minutes or termination prior. The latter were subdivided by device- or user-initiated (with or without an associated alarm), consistent with FDA guidance on real-world benefit-risk considerations and ISO 14971 standards. Clinically significant alarms were defined as alarms leading to blood pump stoppage. Alarm resolution was based on Tablo sensor data. Results: One million consecutive treatments from February 2022 to April 2025 at 628 facilities revealed 81.2% were completed within 5mins of prescribed and 13.2% were terminated >5mins with no associated alarm (Figure 1). Average cartridge use per treatment was 1.1 across all treatment times. Treatment breakdown, achieved time and UF, and alarm data are presented (Table 1). Conclusion: Insourced dialysis with newer technology has been reported to reduce cost and improve efficiency. This large data set from over 600 hospitals expands existing reports to include the clinical effectiveness of this model in achieving dialysis treatment goals for hospitalized patients. Funding: Commercial Support - Outset MedicalTable 1 - Treatment Category Treatments (n) Average Achieved Treatment Time (hrs) Average Prescribed Treatment TIme (hrs) Percent Time Achieved vs Prescribed Average Achieved Ultrafiltration (Liters) Average Prescrbed Ultrafiltration (Liters) Percent Ultrafiltration Achieved vs Prescribed Average Clinically Significant Alarms/treatment Average Alarm Resolution Time (secs) Alarm Rate per Hour Intermittent Hemodialysis 969,279 3.3 (+/-0.6) 3.3 (+/-0.6) 99.1% 1.9 (+/- 1.1) 1.9 (+/-1.1) 98.7% 2.1(+/-5.6) 5.6 (+/-16) 0.67 PIKRT 30,721 16.7 (+/-6.9) 16.6 (+/-7.0) 100.7% 3.1 (+/-2.2) 3.1 (+/-2.1) 99.3% 7.5 (+/-17) 15.3 (+/-57) 0.47 Total 1,000,000 3.6 (+/-2.3) 3.6 (+/-2.3) 98.7% 1.9 (+/-1.1) 1.9 (+/-1.1) 98.7% 2.3 (+/-6.3) 5.9 (+/-19) 0.64