Saturday, May 18, 2024




On May 17, 2024 at 7pmCST, we did a Broadcast with Joshua Dipzinski about the innovations in home dialysis treatment going on at Premiere Dialysis.

You can check out the Broadcast on YOU TUBE at

The main goal of Premiere Dialysis is to raise the bar on the standards of care in home dialysis. Joshua says, "My only goal is to work with my partner to raise the bar on standards of care in dialysis, educate patients, and empower them for home dialysis settings. Premier Dialysis intends to provide patients with the exact amount of dialysis they need while they get a transplant. QLPD & QLHD are the two models of care we use to make this happen."


The aim of Premiere Dialysis is to change the entire home dialysis industry by insuring all patients are given all of their options and not going from zero diaysis to 12 hours a week or 8-10 hours on a PD Cycler. 

The First True Home Dialysis Program means practically all of the necessary patient activities for home dialysis take place in the patient’s home. Blood Draws occur in the patient's home. Physicians, Social Workers and Dieticians meet you at your home. Premier takes any issues with lack of transportation out of the equation.

"All the other companies that provide home dialysis” require a patient to miss work for two weeks, learn at the clinic, then return home to relearn the process in a new environment essentially. Why not learn it one and done in your actual live environment? " says Josh.


There are 3 innovative, alternative protocols to perform peritoneal dialysis at Premiere:


Our QLPD protocol is a dextrose-free, cycler-free dialysis methodology that focuses on a patient’s quality of life recognizing that is the most important concern in a CKD patient’s kidney disease journey.

What can be expected from the QLPD approach?

– Fewer insulin requirements. Patients have seen drops in Hemoglobin A1C after starting our dextrose-free dialysis program.

– Better protection of the peritoneal membrane. Dextrose harms the membrane. It often requires more and more volume and time to achieve adequacy (Kt/V). The dextrose-free Icodextrin solution we employ helps better maintain a patient’s peritoneal membrane. We have patients at three years with NO additional dialysate requirements.

– Cycler-free treatment. Our trademarked approach was created to keep patients from requiring more aggressive forms of home dialysis. A patient’s quality of life vastly improves they’re not required to be strapped to a PD machine for 8-16 hours an evening. Not needing to schedule around dialysis helps both the patient and those they with whom they live.

– More time “to live”. Imagine only 20 minutes daily dedicated to performing dialysis (on average) with QLPD. Our medication management and innovative practices allow patients to fill for 10 minutes at night then disconnect and go spend time with friends and family. In the AM, the patient simply drains for 10 minutes and then goes about their day. No additional exchanges are required.

– Lower hospitalization rate. Although we are a young company, our results are garnering attention in a big way. Our hospitalization rate has been hovering at one-third of the national average. Our clinical staff monitors each patient remotely to keep them safe and happy at home. A patient’s labs are shared with other members of their healthcare team meaning fewer unnecessary needle sticks. No patient should be meant to feel like a pin cushion.

– Proprietary technology. Our patent-pending dialysis tray is designed to reduce infection by placing all cleaning solutions, hand sanitizers, and hold transfer sets in place so the dialysis can be performed one-handed and/or by patients with limited vision or other potential challenges.

– Proprietary app. Available at both the App Store and Google Play, our powerful app features a remote patient management (RPM) tool that reminds patients to chart. When they do chart, a nurse is notified if any vitals are outside of the normal parameters. The nurse is notified of high blood pressure, elevated temperature, or any other concerning changes in the patient’s condition.

– Maintained residual function. Consistent with our belief that patients can be receiving too much dialysis, we use medications and fluids to keep a patient’s kidneys working. That is critical as it can slow or even reduce the disease progression. This results in fewer medications like ESA (to make new red blood cells) and IV iron being needed to maintain optimal lab values. Should those be needed, we are prepared to administer them right in the patient’s home.

According to Josh, what is important here is to, "keep people urinating. Hemodialysis is notorious for restricting fluids and removing a ton of fluid. A body without fluid ends up shutting down the kidneys quickly. At Premier, everyone from QLPD to QLHD gets diuretics and is encouraged to drink fluids (all based on 24-hour urine results)"

2. QLPD Cycler

Our QLPD Cycler protocol, a modified version of our QLPD protocol, is employed when necessary.

– Less cycler time. Our QLPD Cycler ensures less time on the cycler…just enough to achieve what’s needed for kt/v. Reduced cycler treatments help patients remain free to travel while living an almost completely normal life.

– Fewer dextrose solutions. The solutions associated with this approach are often no higher than 1.5% to help protect your peritoneal membrane.


Our QLHD (Home Hemodialysis) also focuses on maintaining a greater quality of life

– Fewer HHD days. Spending less time with hemodialysis means you can spend more time living your best life.

– Focused on your specific needs. Our process focuses on your residual urine volume to help maintain your native kidney functionality.


Josh speaks to the importance of being Dextrose-free:

"QLPD also includes trying to keep patients “dextrose free” as much as possible. In the peritoneal membrane, there are many blood vessels. With traditional PD, the dextrose changes the way those vessels transfer the toxins from the blood to the abdomen. Over time, dextrose exposure makes staying on PD more difficult. In a last-ditch effort to keep a patient on pd, the units bring in icodextrin (extraneal), a sugar-free solution. It is used as a last line of treatment because it costs 3x more than traditional dextrose. Premier utilizes icodextrin as a first-line treatment because not having dextrose PRESERVES the peritoneal membrane. It means that dialysis dosing doesn't have to escalate the same way it does with dextrose-based PD products. Essentially, remaining dextrose-free, we believe, will indicate that people can prolong the standard 2-23 years on PD before switching to hemodialysis. Our goal is to go from PD to transplant without ever seeing hemodialysis. Being dextrose-free is our way to attempt to achieve this. "


One thing many of the major Dialysis Chains have been accused is not informing the patient or adequately explaining to the patient Kidney Transplant as an option for treatment. Frequently, the Chains are accused of being more interested in money than in the individual patient's best interests.

Premiere takes a different approach. Their website clearly states, "We will help you with getting on the transplant list. Our social workers will assist you in achieving what your end goal should be."

Josh addressed this issue: "In the past 3.5 years, we have been fortunate to have six kidney transplants. Many of those were even during our <20 patient phase. We always say that while we have the best dialysis, you can perform for the most negligible impact on life, NO dialysis is way better. In fact, with our model, we have had five occasions where the numbers improved so much that we actually took people off dialysis. The feeling of telling someone to stop dialysis is probably one of the best conversations you can have with someone. Transplants actually impact a clinic score in a major positive way. Despite that knowledge, some companies still would prefer monetary gain over a great clinic score. Overall, I wouldn't dare to call us different: there are many social workers who want to see patients transplanted and make great efforts to help people. We just want to be known as a place you go to not only for easier dialysis regimen but people that want to see you off dialysis altogether. A funny thing can occur: you can put patients' quality of life and mental state first and still be successful while putting patients first."


There any new innovations coming up at Premiere Dialysis!
Transition services for nurses, integrated blood pressure cuffs and weight scales, hands-free charting  where patients receive a phone call to ask for their dialysis documentation to create a “chartless charting.” The big companies have billions over us. They work very hard to prevent us to expand and open new facilities. We can stay ahead by constantly improving our tech and staying current on ISPD guideline.

You can contact Josh at:
Joshua Dipzinski RN BSN CNN

Friday, May 17, 2024


 Did You Miss The Broadcast With JOSHUA DIPZINSKI, CEO & CO FOUNDER OF PREMIER DIALYSIS, working to raise the bar on the standards of care in home dialysis? Catch the Instant Replay Here!

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