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RenalWEB's Daily News Archive

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Thursday, Feb. 2

 Feb. 2, 2012

Comments by Patient Groups Regarding the Essential Health Benefits Bulletin:

Dialysis Outcomes and Analysis of Practice Patterns Suggests the Dialysis Schedule Affects Day of Week Mortality
Advance Online abstract from Kidney International.
Let Patients Sleep During Rounds
Commentary from Renal & Urology News.
Transplantation Unplugged: Follow-up on Kidney Transplantation for a Mentally Retarded Child
Posting from The Kidney Doctor.
Rich Berkowitz: Taking Your Treatment Home
KidneyTalk podcast from Renal Support Network.

PDI in Press Abstracts:

The Effect of Different Doses and Types of Intravenous Iron on Oxidative Stress and Inflammation in Hemodialysis Patients
Article in Press abstract from Journal of Nephrology.
Indications for Vascular Grafts As Hemodialysis Access: Consensus from Experience in Italy
Article in Press abstract from the Journal of Vascular Access.

Advance Online Abstracts from Kidney International:

African-American Kidneys May Worsen Transplant Outcomes
Article from Renal & Urology News.
IOM Report Targets Strategies to Reduce Chronic Illness
New Diabetes Combo Agent Gets FDA Nod
A Quick and Beautiful Online Course About Bone Biology from Amgen
CBO: Federal Health Spending To Double Over The Next Decade
News summary from Kaiser Health News.
Sugar Tax Needed, Say US Experts
Article from the BBC.
If Patients Bash You on Internet Rating Sites, Consider This
(Registration required, but free.) Article from Medscape News.
A Computer Beats A Pen For Getting Prescriptions Right
Article from NPR and Kaiser Health News.

National Quality Forum's Measures Application Partnership (MAP) Issues Final Pre-Rulemaking Recommendations
News item from AHANews.com.

See pages 109-111 of MAP's Pre-rulemaking Report (274-page pdf) for the recommendations for end-stage renal disease.

Editor's note: They missed the obvious and best public example of excellence in dialysis care — the percentage of working-age patients that are employed.

CMS To Hold Special ESRD Open Door Forum - Conference Call on Thursday, Feb. 2, 2:00-3:30 PM EDT
CMS will hold a Special Open Door Forum (ODF) to discuss the final rule for the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) for Payment Years (PY) 2013 and 2014 and the related baseline data for PY 2014.

To participate by phone: Dial: 1-800-837-1935 (toll free) Conference ID#: 47110132.

Discussion materials (51-slide presentation) available now.
Medicare Advantage Premiums Down 7%, Enrollment up 10%


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Wednesday, Feb. 1

 Feb. 1, 2012
Dialysis Unplugged: "Cutting off Your Nose to Spite Your Face"
Posting by Dr. Ajay K. Singh from The Kidney Doctor. Also see this related posting by Dr. Peter Laird from HemoDoc and "A Return to Patient-Focused Care" from Hospitals and Health Networks.

Editor's note: Yes!  Psychosocial factors do matter most for patients!

I believe Northwest Kidney Centers perfectly defined patient-centered dialysis care — over 45 years ago!  See this section of the essay "Return to a Patient-Centered Model for Dialysis Care" from FixDialysis. They produced such impressive results that Congress agreed to pay for dialysis for all.

As for a marker for patient-centered dialysis care, I haven't been able to identify one that could apply to all patients and could motivate every member of the healthcare team. However, targeting increased employment rates for working-age patients would drive tremendous positive changes that would benefit all patients. Providing financial incentives for nephrologists and providers to increase patient employment rates would immediately stop many of the counterproductive practices in the dialysis industry today, would reintroduce psychosocial factors into dialysis care, and would prevent the unnecessary debilitation of hundreds of thousands of CKD patients — as well as eliminate the enormous disability costs for taxpayers!
"I Need to have Control In my Life" - Celebrating Five Years of Borrowed Time
Posting by Dr. Peter Laird from HemoDoc.
Dosing Dialysis in Acute Kidney Injury: What Have We Learned From Clinical Trials?
Q&A blog posting from eAJKD.
Arbor Research: 2012 Technical Expert Panels
Press release.

Editor's note: Any psychosocial factors being considered? Arbor Research and DOPPS continue to miss the point.
Kidney Transplant Refused to California Father in US Illegally
Article from USA Today. Related blog posting from The Kidney Doctor.
Vitaflo USA Announces Nationwide Voluntary Recall of Renastart Medical Food
Notice from the FDA web site.
Acute Removal of Common Sepsis Mediators Does Not Explain the Effects of Extracorporeal Blood Purification in Experimental Sepsis
Free, full-text article from Kidney International.
Proof of Principle Study to Detect Metabolic Changes in Peritoneal Dialysis Effluent in Patients Who Develop Encapsulating Peritoneal Sclerosis
Advance Access abstract from NDT.
Serum Cystatin C As a Predictor for Cardiovascular Events in End-Stage Renal Disease Patients at the Initiation of Dialysis
Online First abstract from Clinical and Experimental Nephrology.
Dietary Salt Influences Postprandial Plasma Sodium Concentration and Systolic Blood Pressure
Free, full-text article from Kidney International.
New Agent Improves Kidney Transplant Survival in Mice, Likely to Speed Replacement of Other Organs
Diabetics at Greater Risk of Kidney Cancer
JAMA: Prevalence of Obesity and Trends in Body Mass Index Among US Children and Adolescents, 1999-2010
Prevalence of Obesity and Trends in the Distribution of Body Mass Index Among US Adults, 1999-2010
Government Health Spending Seen Hitting $1.8 Trillion
Article from Reuters.
Recommended Adult Immunization Schedule: United States, 2012
Early Release clinical guidelines and press release from Annals of Internal Medicine.
Survey: More Nurses Spend at Least 2 Hours on Indirect Patient Care
Too Much Testosterone Linked to Inflated Ego: Study
Report: CMS Medicare Advantage Adjustment Too Low


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Tuesday, Jan. 31

 Jan. 31, 2012
FDA Innovation Challenge: End-Stage Renal Disease
This pilot will test the tools and processes being developed for the Innovation Pathway, a program that FDA created to shorten the overall time it takes for the development, assessment, and review of breakthrough medical devices. Through new decision tools that help the FDA assess and characterize the benefits and risks of medical devices, and enhanced collaboration between the FDA and entrepreneurs, the Innovation Pathway will accelerate the introduction of new technologies that improve public health.

Editor's note: With one provider owning nearly 35% of the clinics and selling their own dialysis machines — and another provider owning 35% of the facilities with its own existing purchasing agreements, how much of a market is there for entrepreneurs? It may be that at best an entrepreneur can hope that his his/her company is bought by a competitor, but the technology may still never reach the patients.

What happened to the HemaMetrics Crit-Line? Patients loved it.
First DaVita Primary Care Clinic To Open in Tacoma
Article from The Bellingham Herald.
P-4-P and Dialysis Centers: Look Beyond URR
(Registration required, but free.) Video blog from Berns on Nephrology from Medscape Nephrology.
Northwest Kidney Centers Celebrates 50th Anniversary
Press release.
Parade Calls Hemodialysis a Grueling and Painful Procedure
Blog posting from HemoDoc.
Acute Dialysis Risk in Living Kidney Donors
Free, full-text, Advance Access article from NDT.
Prevalence, Determinants and Prognosis of Pulmonary Hypertension among Hemodialysis Patients
Advance Access abstract from NDT.
Oxidative Stress, Antioxidant Therapies and Chronic Kidney Disease
Accepted Article abstract and full-text article (31-page pdf) from Nephrology.
Antioxidant Therapy in Hemodialysis Patients
(Registration required, but free.) Free, full-text Kidney International review article via Medscape Nephrology.
Epidemiology of Chronic Kidney Disease in Children
Free, full-text review from Pediatric Nephrology.
Stopping Steroids Safe after Kidney Transplant
Article from MedPage Today.
Hemodialysis-Induced Alterations in Macular Thickness Measured by Optical Coherence Tomography in Diabetic Patients with End-Stage Renal Disease
Abstract from Ophthalmologica.
AMAG Pharmaceuticals Announces Completion of Enrollment in its Phase III Program Evaluating Feraheme for a Broader Iron Deficiency Anemia Indication ‎
Overweight Physicians Less Likely to Tackle Patient Weight
Virtual Forms Increase Kidney Donor Applications 40 Percent
Health Reform Law Gaining Wider Acceptance: Poll
Article from HealthDay.
FDA Fired Device Whistleblowers
Posting from GoozNews.
Mandatory Overtime Caps for Nurses Having Effect
QIMS Registration Now Live for All CROWNWeb Users
See "Latest News" column on Project CROWNWeb home page.
OIG: Data Inconclusive About Why Docs Leave Medicare


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Monday, Jan. 30

Northwest Kidney Centers Celebrates 50th Anniversary

 Jan. 30, 2012
Sustainability: the Seventh Dimension of Quality in Health Care
Abstract of editorial and related abstact from Hemodialysis International.
Dialysis Unplugged: Just Say it Ain’t So
Posting by Dr. Ajay K Singh from The Kidney Doctor.

Edtor's note: Another study of the potential benefits of longer and/or more frequent dialysis treatments will do nothing to improve patients' lives. It will not drive the equipment manufacturers to develop the smaller, more portable, easier-to-use dialysis devices and machines that will make more dialysis much more bearable and will also greatly improve patients' lives and long-term outcomes.

"The original – and forgotten – intent of our national taxpayer-funded dialysis program was to support working patients. In order to continually improve outcomes that are important to patients and taxpayers, renal replacement therapy must be synonymous with long-term patient employment and rehabilitation."
Incentives of Death: The CMS Payment Systems
Blog posting from HemoDoc.

Editor's note: I would ask who convinced Congress and CMS that the bundle was best for patients. Who has that kind of influence... and the most to gain?

Any examination of the problems of the American dialysis system must include the many financial disincentives that exist for improving patients' lives and their care. Separating Medicare Part A and B means that when the dialysis provider has the local hospital "acute" dialysis contract, dialysis providers make more profit when a patient is hospitalized.

For another example, current Medicare Secondary Payer (MSP) period policy means that patients are only a source of profit for the first 30-33 months that they are on dialysis. This means that in business terms, the best dialysis patient is one that dies, gets transplanted, or is transferred out of the clinic after 30 months of in-center dialysis. There are no incentives to develop the technology that would extend patients' lives beyond this period.

Latest Product Recalls - FDA Enforcement Report for Jan. 25

  • AngioDynamics DURAMAX Chronic Hemodialysis Catheters - Class II recall (located approx. 80% of way down the page)
  • NxStage Pureflow SL SAK-303 Dialysate Sacks - Class III recall (last item on page)
The UNOS 'Preferential Allocation' Concept Proposal for the Allocation of Deceased Donor Kidney Transplants: Implications for Patients with Diabetes
Free, full-text, Advance Access editorial from NDT.
The Impact of Ferritin Fluctuations on Stable Hemoglobin Levels in Hemodialysis Patients
Online First abstract from Clinical and Experimental Nephrology.
The Effects of Fish Oil Supplementation on Markers of Inflammation in Chronic Kidney Disease Patients
Article in Press abstract from Journal of Renal Nutrition.
Treatment of Septic Shock with Continuous HDF Using Two PMMA Hemofilters for Enhanced Intensity
Article in Press abstract from The International Journal of Artificial Organs.
Weekly Shot Gets FDA Nod for Type 2 Diabetes
Article from WebMD.
Vasc-Alert Introductory Webinar
Scheduled for Wednesday, Feb. 1 at 3 PM EST. Register to reserve spot.
Deadly Kidney Disease Plagues Central Americans
FDA OKs Axitinib for Kidney Cancer
Tokyo Doctor, Wife Jailed for Buying Illegally Harvested Kidney
The Flexible Benefits of Stretching
Hospital Hiring of Physicians Picks up Steam
Article from American Medical News.
Blood Pressure Differences Between Arms Could Signal Heart Risk
Article from HealthDay.

Editor's note: NEVER take blood pressures on a patient's arm where an AV fistula or dialysis graft exists!
AHRQ: Hospitals Showing Improvement in Teamwork, Patient Safety
Affordable Care Act Will Save States and Taxpayers $17.7 on Prescription Drugs


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Fri./Sat., Jan. 27-28

 Jan. 27, 2012
Amgen Misses Fourth-Quarter Profit Estimates as Anemia Drug Sales Tumble
Article from Bloomberg. Press release from Amgen.
Managing CKD Anemia: 10 to 12 Isn't Being Nice, It's Just Being Stubborn
Posting by Dr. Ajay K. Singh on The Kidney Doctor.
Iron Deficiency in CKD: the Role of Hepcidin and Ferroportin
Posting by Dr. Ajay K. Singh on The Kidney Doctor.
Heparin or Citrate: What is the Evidence?
Blog entry from eAJKD.
On Motivating Patients
Free, full-text, Online First editorial from Archives of Internal Medicine.

Editor's note: Read the last three paragraphs. Instead of continuing to pursue biochemical markers....
The Japanese Dialysis Survival Debate
Blog entry from HemoDoc.

CJASN Express Abstracts:

Early View Abstracts from Hemodialysis International:

System to Deliver Organ Transplant Drug (cyclosporine) – without Harmful Side Effects
Press release from University of Strathclyde.

TN Man with Wife's Kidney Blames Vanderbilt for Organ Decline
Article from The Tennessean.
Exercise May Boost Mood for Some Chronically ill
Article from Reuters.
Mayo Clinic Finds Mild Cognitive Impairment is Common, Affects Men Most
Study: Diabetes Affects Hearing Loss, Especially in Women
Statins May Stave Off Liver Cancer in People With Hepatitis B
New NIH Fact Sheet Explains Test for Diabetes, Prediabetes
Baxter Reports Sales and EPS for Fourth Quarter and Full-Year
Amgen Buys Micromet for Antileukemia Drug
Top Challenge for CEOs: Moving from Volume to Value
News item from HFMA.
Workplace Safety Program Can Reduce Injuries If Aggressively Enforced, Study Finds
Press release from RAND Corporation.
Enema Transplant Works for Stubborn C. diff Infection: Study
Article from Reuters.
Hospital Stays Involving C. difficile Infections Leveled Off After 300 Percent Increase Since 1993
Elevated Risk Factors Linked to Major Cardiovascular Disease Events across a Lifetime
Obama Administration officials, Health Care Leaders Joined Together at Innovation Summit
 


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Thursday, Jan. 26

On Motivating Patients
Free, full-text, Online First editorial from Archives of Internal Medicine.

Editor's note: Read the last three paragraphs.
 Jan. 26, 2012
Global Nephrology: Better Cars in Japan Maybe, but also Better Dialysis?
Posting by Dr. Ajay K. Singh from The Kidney Doctor.

Editor's note: I believe the reasons for the differences in mortality rates between Japan and the U.S. are multifactorial and beyond biochemical markers. Some not routinely mentioned are the use of RNs in Japan (not techs) and cultural psychosocial differences (that may effect compliance and depression). The elderly are revered in Japan, while the U.S. culture reveres work/success — a concept with little support in the American dialysis system. I believe far more Americans withdraw from their dialysis treatments.

Patients May Die When Doctors Moonlight as Big Pharma’s “Key Opinion Leaders”
Article on Procrit/Epogen from Care2.com (blog). Related article from Truthout.

Editor's note: I believe this issue should not be ignored.

On Jan. 5th, the American Association of Kidney Patients (AAKP) announced their 2012 Medal of Excellence winners. One of them was Dr. Charles McAllister, a former Chief Medical Officer at DaVita.

If the AAKP does not want to be seen as anything but an industry lap dog, it needs to explain why it is giving him this award and who nominated him — especially considering his past public stances on EPO doses.

This is an excerpt from a Sept. 14, 2006 article in The Boston Globe by Christopher Rowland, "AS KIDNEY DRUG DOSES RISE, SO DO WARNINGS":

DaVita's national medical director, Charles McAllister, said (Dr. Ajay K.) Singh's recommendation that the FDA's limit (for Epogen) be observed does a "disservice" to dialysis patients.

"Our doctors continue to aggressively manage anemia there isn't any over-utilization," McAllister said. "I think we should be using more epo."

EPO was a source of profits for DaVita. Among the largest dialysis providers, DaVita gave the largest doses of EPO in the industry during his tenure. DCI, a large non-profit provider, gave far smaller doses of EPO and had better patient outcomes than DaVita or Fresenius. (And who received the 2011 AAKP Medal of Excellence Award?)

FDA Fails To Approve Cholesterol Drug (Vytorin) for Kidney Disease
Articles from Reuters, MedPage Today, FiercePharma, and BloombergPress release from Merck.
Buttonhole Cannulation: Avoiding Fistula Infections
Posting by Dr. Peter Laird from HemoDoc.
NIH Kidney Disease Experts Urge: Get Involved
Press release from the National Institutes of Health.
Mortality Associated with Dose Response of Erythropoiesis-Stimulating Agents in Hemodialysis versus Peritoneal Dialysis Patients
Issue in Progress abstract from American Journal of Nephrology.
Femoral Versus Jugular: Part Three
Blog posting from the Renal Fellow Network.

Early View Abstracts from Seminars In Dialysis:

Adiponectin and Cardiovascular Outcomes among Hemodialysis Patients
Issue in Progress abstract from Kidney & Blood Pressure Research.
One-on-One Interviews Begin in Jury Selection for DaVita Clinic Murder Trial
Articles from the Lufkin Daily News and KTRE.
Poster: Protect Your Access – It's Your Lifeline!
1-page pdf from the Northwest Renal Network.

Online Tools Increases Efficiency, Speed of Kidney Donor Screening
Article from Renal and Urology News.

Long Shifts May Raise Some Nurses' Odds for Obesity
Article from HealthDay.
Deaths from Heart Attacks Halved in Last Decade in England
Article from the BBC.
Will You Have a Heart Attack or Stroke?
Press release from Northwestern University. Preview of article from The New England Journal of Medicine.
Can Insurers Charge You More Due To A Pre-Existing Condition?
Video from Kaiser Health News.
Will Health Information Exchanges Live Up to Their Promise?
Article from Hospitals & Health Networks.
Selling Bone Marrow — Flynn v. Holder
Free, full-text, perspective piece from The New England Journal of Medicine.
Many New Doctors Regret Choosing Medical Career
Article from Medical Economics.
USDA Sets Guidelines for Healthier School Meals
Update on Massachusetts Health Reforms
Cardiologists Suggest Patient Centered Approach to Replacing Implantable Cardioverter Defibrillators
LowestMed’s New App Uses GPS to Find Best Prescription Prices Near You
CMS To Hold Special ESRD Open Door Forum - Conference Call on Thursday, Feb. 2, 2:00-3:30 PM EDT
CMS will hold a Special Open Door Forum (ODF) to discuss the final rule for the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) for Payment Years (PY) 2013 and 2014 and the related baseline data for PY 2014.

To participate by phone: Dial: 1-800-837-1935 (toll free) Conference ID#: 47110132.

Discussion materials will be available to download at http://www.cms.gov/ESRDQualityImproveInit/ by January 31, 2012.
CMS Sets Deadline for 2011 Meaningful Use Payments
 


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Wednesday, Jan. 25

New FDA Approved Labeling For VYTORIN® Includes Results From the Study of Heart and Renal Protection (SHARP) in Patients With Moderate to Severe Chronic Kidney Disease
 Jan. 25, 2012
DaVita Acquires Majority Stake in NephroLife India
Press release.
Affymax Prepares to Mount First Challenge to Amgen Anemia Drug Monopoly
Article from Xconomy.com.
Is Just Being NICE the Secret Answer to Anemia Management in CKD Patients?
Blog posting by Dr. Ajay K. Singh from The Kidney Doctor.
Rate of Leg, Foot Amputations Among Diabetics Drops: CDC
Articles from HealthDay, AP, and MedPage Today.
Association of Deprivation (poverty) with Worse Outcomes in Chronic Kidney Disease: Findings from a Hospital-Based Cohort in the United Kingdom
Issue-in-Progress abstract from Nephron Clinical Practice.
Is Conventional Hemodialysis Enough to Manage Carbamazepine Intoxication?
Issue-in-Progress abstract from Blood Purification.
New Study Reconsiders Blood Pressure Targets for Kidney Disease Patients
Press release from the National Kidney Foundation. Abstract from Archives of Internal Medicine.
FDA Grants IDE Nod to Innovative High Blood Pressure Device
Percentage Of Americans Who Lack Health Coverage Up For Fourth Straight Year
News summary from Kaiser Health News. Report from the CDC.
Kaiser Permanente Makes Electronic Medical Records Accessible to Patients Through Android App and Mobile Website
Article from MedGadget.com.
Boosting Health Literacy
Free, full-text article from Health Affairs.
Baltimore Leads Nation in Best Overall Hospital Care
Positive Psychology Has Limited Health Benefits: Research
CMS Cost Report Filing Date Extended to 02/29/12 for Fiscal Year 06/30/11 Filers
News item from NRAA.
New CBO Report Supports Innovation Center’s Approach to Improving Care
CMS Announces Medicare EHR Incentive Program Appeals Process


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Tuesday, Jan. 24

 Jan. 24, 2012
In England, Fresenius Medical Care Cuts Out Evening Sessions at Sheffield Dialysis Center
Article from the BBC.

Editor's note: At the most fundamental level, this is NOT what medical care should do. First, do no harm.

As in the US, multi-billion-dollar dialysis corporations are increasing their overseas profits by medically disabling the patients that they are expected to serve. How can these corporate medical directors continue to ignore the effects that corporate actions like this have on the patients (and families) entrusted to their care?

These corporations are also conveniently ignoring the additional costs of widespread dialysis patient disability. While this hospital district may save some money on treatments, the government will have more people on the dole.

"In order to continually improve outcomes that are important to patients and taxpayers, renal replacement therapy must be synonymous with long-term patient employment and rehabilitation."
Kt/V urea Does Not Tell It All
Free, full-text, Advance Access editorial comment from NDT.

Conflicting Abstracts on Effect of Depression on Mortality in Dialysis Patients:

Effect of Exercise Training on Depressive Symptoms Among Patients With a Chronic Illness
Abstract from Archives of Internal Medicine.

Advance Access Abstracts from NDT:

Nocturnal Leg Cramps and Prescription Use That Precedes Them
Abstract from Archives of Internal Medicine.
Jury Selection Begins for Former Lufkin Nurse Accused of Killing Five Patients with Bleach
Article from KTRE. News summary from RenalWEB.
Confidence, Positive Feelings Support Better Medication Adherence in Hypertensive African-Americans
Wisconsin Dialysis Patient Almost Didn't Claim $14.3 Lottery Prize
Hawaii Lawmakers Fast-Track Money for Kidney Transplant Center
Organ Donor Rates Climbing Too Slowly, Warns UK Charity
Diaverum Cares for 20,000 Dialysis Patients
DaVita Appoints Christopher Riopelle as Senior Vice President
Aethlon Medical Establishes Extracorporeal Therapy Scientific Advisory Board
California Congressman Visits Fresenius Dialysis Facility
Patient Centered Outcomes Research Institute (PCORI) Issues Draft Comparative Effectiveness Research Priorities/Agenda
PCORI will provide a 53-day public comment period on its first National Priorities for Research and Research Agenda. The comment period concludes at 11:59 p.m. ET on Thursday, March 15, 2012.
Study: Stem Cells May Aid Vision in Blind People
Articles from AP and AFP.
Psychedelic Mushroom Trips Point to New Depression Drugs
States, Health Industry Moving Ahead On Implementing Health Law
News summaries from Kaiser Health News and HFMA.


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Monday, Jan. 23

 Jan. 23, 2012
Jury To Be Picked for Fatal Bleach Injections Case at DaVita Clinic in Lufkin, Texas
AP news item. News summary from RenalWEB.
New (PowerPoint) Lecture: Initiation of Dialysis
Blog posting and 113-slide presentation by Dr. Joel Topf, MD from Precious Bodily Fluids.
Dialysis Unplugged: The Transition from CKD to ESRD
Blog posting by Dr. Ajay K. Singh from The Kidney Doctor.
Do-It-Yourself Renal Dialysis? Yes, It's Dialysis Done Different
Article from Soo Today (Sault Ste. Marie, Ontario).

Postings by Peter Laird, MD from HemoDoc:

NHSN Enrollment for Dialysis Facilities - CMS QIP
Instructions for dialysis facilities to enroll in the CDC's National Healthcare Safety Network (NHSN) dialysis events/infection program.

ESRD Network 4 is offering a 4-part webinar on NHSN requirements. To access the webinar series, see the box on left side of their home page. The next upcoming webinar is January 27th.

Current Topics in CKD: Calcification
(Registration required, but free) Series of articles from Medscape Nephrology.
In a Few Words
Blog posting from Renal Fellow Network on the on-going series of personal essays in the American Journal of Kidney Diseases.
The MDRD Equation Underestimates the Prevalence of CKD among Blacks and Overestimates the Prevalence of CKD among Whites Compared to the CKD EPI Equation: a Retrospective Cohort Study
Provisional abstract and full-text article (33-page pdf) from BMC Nephrology.
Even Mild Dehydration May Cause Emotional, Physical Problems
Article from WebMD.
A Simple Height Independent Equation for Estimating Glomerular Filtration Rate in Children
Online First abstract from Pediatric Nephrology.
Starting a Support Group
KidneyTalk podcast from Renal Support Network.
Toronto Man Who Bought Kidney Abroad Is Key Witness in Transplant Sale Trial in Kosovo
Ontario, BC Residents Wait Longer for Kidney Transplants Than Any Other Canadians

RSN Annual Renal Teen Prom 2012 "An Enchanted Evening"

Biosimilar Drug Era Dawns
Treating Diabetes, Depression Together May Make Sense
Stories About High Health Care Costs Win Prizes
Posting from Shots, NPR's Health Blog.
The Price of Your Soul: How the Brain Decides Whether to 'Sell Out'
Press release from Emory University.
Surface Plasmonic Biochip to Detect Glucose Levels in Saliva
Article from MedGadget.
ECRI Offers Ways to Reduce Social Media Risks
Article from Healthcare IT News.
CBO: Medicare Demonstrations Haven’t Reduced Spending
News item from HFMA.
Boehner, Ryan Say House GOP Will Again Seek To Revamp Medicare
News summary from Kaiser Health News.
Medicaid Medical Homes Saved $1 Billion in North Carolina
Article from American Medical News.

"However, sicker enrollees and those eligible for both Medicare and Medicaid have posed more challenges for the program."


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Fri./Sat., Jan. 20-21

 Jan. 20, 2012
New ESA Drug Labels for Kidney Disease Patients – What Do They Mean?
Press release and CJASN Express abstract from the American Society of Nephrology.
Emerging DOPPS Dialysis Trends in America
Posting by Dr. Peter Laird from HemoDoc.
Kidney Failure Patients Prone to GI Tract Bleeding
Article from HealthDay. JASN Express abstract.
Abstracts from the 14th International Conference on Dialysis / Advances in CKD 2012
(12-page pdf) Full-text, Issue-in-Progress section from Blood Purification.
Fresenius Medical Care Salutes Patients Who Prioritize Fitness and Health
Press release.

Editor's note: 40 years after the start of the federal dialysis program, this is where the largest dialysis provider is at in terms of patient quality of life — encouraging exercise and a good diet. No mention of patient employment. No mention of rehabilitation programs.

Is this what taxpayers deserve after spending hundreds of billions of dollars over the last 40 years?

Abstracts from Atherosclerosis:

The Correlation of Antidepressive Agents and the Mortality of End-Stage Renal Disease: a Health Insurance Research Database Study in Taiwan
Accepted Article abstract from Nephrology.

CJASN Express Abstracts:

Regression of Left Ventricular Mass Following Conversion from Conventional Hemodialysis to Thrice Weekly in-Center Nocturnal Hemodialysis
Provisional abstract and full-text article (25-page PDF) from BMC Nephrology.

Free, Full-Text Articles from The Journal of Renal Nutrition:

Issue in Progress Abstracts from Blood Purification:


Joslin Study Identifies Novel Markers As Key Indicators of Future Renal Failure in Diabetes
Press release from Joslin Diabetes Center.
Renal Ventures Management Acquires Five Dialysis Clinics in Southeast Texas
National Report Finds One in Five Americans Experienced Mental Illness in the Past Year
Press release from the Substance Abuse and Mental Health Services Administration.
FDA Rejects Dapagliflozin for Type 2 Diabetes
The KHN Conversation: 'Innovation' Advisors On Achieving CMS' Triple Aim
Article from Kaiser Health News.
CBO Report Card: Poor Grades For Some Medicare Cost Cutting Efforts


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Thursday, Jan. 19

 Jan. 19, 2012
The Drum Beats of a New Dialysis Randomized Trial are Growing
Posting by Dr. Peter Laird from HemoDoc.

Editor's note: Until psycho-social factors are considered, any new RCT is likely to suffer from many of the same unacknowledged design flaws and confounding variables as previous studies.

Many patients are reluctant to agree to more dialysis time because it means spending more time away from their normal activities of daily living, as well as spending more time in an environment where they have little control — which is also often unpleasant, noisy, boring, and sometimes hostile ("life-sucking" says one).

If we had time to do all the studies, we would likely find that the best renal replacement therapy is a wholistic approach: individualized daily hemodialysis, for at least six hours, is portable and convenient, can be combined with restorative sleep, minimizes recovery time, minimizes disruptions in patients' lives, maintains the patients' careers and lifestyles, and includes substantial psycho-social support programs and structures. With accompanying technological developments that provides this kind of treatment (which we should have seen!), the overall societal costs of CKD5 would be lower and the benefits would be far greater than those seen today. We can do so much better — starting right now.
Proposed System for Transplant Kidney Allocation Contains Bias against Most Diabetics
Article by Dr. Stephen Ponder from Corpus Christi Caller Times.
"Southern Food" Chef Paula Deen Hid Diabetes, Pushed High-Fat Food
Article from AP.
Fresenius Medical Care Successfully Places Senior Notes
Press release.
"High-Normal" Blood Pressure Linked to Atrial Fibrillation
Article from The Heart. Abstract from Hypertension.
The Bioethics of Denying Patients Organ Transplants
Audio program from The Takeaway. Blog postings from The Washington Post and The Kidney Doctor.
New Drug Combo for Hepatitis C Shows Promise
Article from HealthDay.

Comparative Effectiveness of Incident Oral Antidiabetic Drugs on Kidney Function
Free, full-text article from Kidney International.

Crazy Numbers: Largest Drop in Hemoglobin without a Transfusion
Blog posting from Precious Bodily Fluids.
Endovascular Treatment of Hemodialysis Arteriovenous Fistulas: Is Immediate Post-Interventional Blood Flow a Predictor of Patency
Article in Press abstract from the Journal of Vascular Access.
ISHD To Present 2012 Belding H. Scribner Trailblazer Award in Hemodialysis to Lee Henderson, MD
Are Health Law Backers Nervous About The High Court's Review?
News summary from Kaiser Health News.
White House Issues Progress Report on State Insurance Exchanges
News item from AHANews.com. Report (9-page pdf) from WhiteHouse.gov.
Faulty French Breast Implants May Upend U.S. Device Debate
Confirming the CMS Nominee — Overcoming Poisonous Politics
Free, full-text, perspective piece from the New England Journal of Medicine.


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Wednesday, Jan. 18

 Jan. 18, 2012
Fresenius Medical Care Plans $1.52 Billion Junk Debt Sale as Yields Drop to Five-Month Low
Article from Bloomberg. Press release from Fresenius Medical Care.
Global Nephrology- Dialysis in India
Posting by Dr. Ajay K. Singh from The Kidney Doctor.
The Brave New World of the Renal Bundle
Posting from HemoDoc.
New Jersey Parents Say Mentally Disabled Girl, Three, Denied Kidney Transplant; Experts Say Situation Is Complex
Articles from The Washington Post and AP. Blog posting from BioEdge. Also see:

- 15,000 Demand Transplant for Mentally Delayed Child
Kidney Failure Risk Higher for Liver Transplant Patients Following Allocation Policy Change
Press release from the University of Michigan Health System.
Rapid Diagnosis of Severe Kidney Damage — New Biomarkers Tested
Press release from Helmholtz Association of German Research Centres.

Free, Full-Text Articles from American Journal Of Kidney Diseases:

Impact of the Fukushima Daiichi Nuclear Power Plant Accident on Hemodialysis Facilities: An Evaluation of Radioactive Contaminants in Water Used for Hemodialysis
Early View abstract from Therapeutic Apheresis and Dialysis.

Advance Access Abstracts from NDT:

Vitamin D Status in Dark Skinned Patients Undergoing Hemodialysis in a Continually Sunny Country
Article in Press abstract from Journal of Nephrology.

Articles in Press Abstracts from the Journal of Vascular Access:

Taking Multiple Meds Ups Fall Risk
Texas Congressman Visits DaVita Dialysis Center
Nephros Receives Euro 750,000 Payment from Bellco S.r.l.

A Penny-Per-Ounce Tax On Sugar-Sweetened Beverages Would Cut Health And Cost Burdens Of Diabetes
Abstract from Health Affairs.

US Obesity Epidemic Shows No Hint of Shrinking
Article from AP. Report from the CDC.

Effects of Tamiflu Still Uncertain, Warn Experts, As Roche Continues to Withhold Key Trial Data
La Nina 'Linked' to Flu Pandemics
Enhancing Cognition in Older Adults Also Changes Personality
Transcript from Jan. 12th MedPAC Meeting
(WARNING: 446-page pdf document)  The Medicare Payment Advisory Commission discusses the payment adequacy of outpatient dialysis on pages 101-113.
Congress Returns To Work On D.C. With 'Doc Fix'
News summary from Kaiser Health News.
RPA Public Policy in a Minute - January 2012
Video from the Renal Physicians Association.


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Tuesday, Jan. 17

Fresenius Medical Care Plans $1.52 Billion Junk Debt Sale as Yields Drop to Five-Month Low

 Jan. 17, 2012
Dialysis Unplugged: Is Change Possible?
Posting by Dr. Ajay K. Singh from The Kidney Doctor.

Editor's note: Having been talking and writing about "fixing dialysis" for three years, I have found it is very hard for any group to reach a consensus — there are just so many ideas about what is wrong, who is responsible, and how to fix it.

Instead of trying to pick a "winner," I believe what is needed is to have an over-arching philosophy that can contain everyone's ideas, solutions, and efforts. This philosophy should also drive change in every individual, company, product, and organization involved in dialysis care — immediately.

Could this statement act as an over-arching philosophy that would allow everyone to pursue their own ideas and beliefs?

"In order to continually improve outcomes that are important to patients and taxpayers, renal replacement therapy must be synonymous with long-term patient employment and rehabilitation."

Couldn't we begin talking, thinking, and doing as if this were already our national policy (a la Vaclav Havel)?

Call to Arms…
Free, full-text editorial from Journal of Renal Nutrition.

Editor's note: You know dialysis care has become wildly dysfunctional when even the dietitians are calling for change.
Dialysis Unplugged: When if Not Now?
Posting by Dr. Ajay K. Singh from The Kidney Doctor.
Evotec and Harvard University Expand Strategic Alliance Into Kidney Disease
Press release.
Xerostomia (dry mouth) in Patients on Chronic Hemodialysis
Advance Online abstract from Nature Reviews Nephrology.
Forced Diuresis Can Cut Risk of Contrast Nephropathy
Article from MedPage Today.
Effect of Administration Route on the Renal Safety of Contrast Agents: a Meta-Analysis of Randomized Controlled Trials
Article in Press abstract from Journal of Nephrology.
Jack Black Skips Golden Globes and Reigns at 13th Annual Renal Teen Prom
Article from Patch.com. Video from KARE.
'Team Amelia' Backs Kidney Transplant for Special Needs Child
Article from USA Today.
Australia Hits Record Number of Organ Donors: Risks of Living Organ Donation
Article from International Business Times.
A Washington State Patient Writes about Dialysis: It's a Really Bad Part-Time Job
New Group To Set Priorities for Medical Effectiveness Research
Article from Kaiser Health News.
Study Faults Research Linking Hormone Therapy to Breast Cancer
Injuries to Pedestrians Wearing Headphones Tripled Since 2004
NCQA: Six Providers Seek ACO Accreditation


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Monday, Jan. 16

 Jan. 16, 2012
An Economic Assessment Model for in Center, Conventional Home, and More Frequent Home Hemodialysis
Free full-text article from Kidney International.

Postings from HemoDoc:

DaVita Unit Acquired ModernMed
News item from Zachs Equity Research.
Novel Antimicrobial Resistant Bacteria among Patients Requiring Chronic Hemodialysis
Published Ahead-of-Print abstract from Current Opinion in Nephrology and Hypertension.
Bisphosphonate Therapy, Death, and Cardiovascular Events Among Female Patients With CKD: A Retrospective Cohort Study
Article in Press abstract from American Journal of Kidney Diseases.

Online First Abstracts from International Urology and Nephrology:

Advance Access Abstract from NDT:

Reversal of Diabetic Nephropathy: Lessons from Pancreas Transplantation
Article in Press abstract from Journal of Nephrology.
Management of Dialysis Access Associated "Steal" Syndrome with DRIL Procedure: Challenges and Clinical Outcomes
Article in Press abstract from the Journal of Vascular Access.
California Dialysis Patient Fears Deportation
Article from the Sacramento Bee.
Nurse Donates Own Kidney to Patient in Need
Press release from Emory Healthcare.
5 Percent Of Americans Account For Half Of Nation's Health Care Spending
Article from Kaiser Health News.
NIH Study Shows 32 Million Americans Have Autoantibodies That Target Their Own Tissues
Press release from National Institutes of Health.
Data: Hospice Programs Grow in Popularity
Article from Hospitals & Health Networks.
Drug Shortages Raise Risk of Cancer Counterfeits, U.S. Says
ACA to Bring Influx of Diabetics to Medicaid
Project CROWNWeb: QIMS Initial SO and Initial EUM Training Videos Now Available
See "Latest News" section on the CROWNWeb home page.


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Fri./Sat., Jan. 13-14

DaVita Unit Acquired ModernMed

 Jan. 13, 2012
Dialysis Unplugged: Follow-up to the 2009 Boston Conference
Posting by Dr. Ajay K. Singh from The Kidney Doctor.

Editor's note: One of the goals of this conference was to "think outside the box." Thinking about this conference for the last three years, I now see that this conference was never able to get outside of the "medical" approach. It did not include financial incentives/motives for care. Patients were not invited to participate and there were no presentations on psychosocial issues, employment, or rehabilitation. During its four days, it never touched on the benefits of a holistic or well-patient approach to care management. Patient groups have not embraced its conclusions or follow-up actions.

Until we are willing to embrace the importance of the care of whole patient, the benefits of high quality of life, employment and rehabilitation, as well as the negative effects of debilitation, dialysis care will continue to be broken and "stuck."

If we are looking for an essential clarity of purpose, I would suggest an excellent place to start would be by redefining the ESRD program as a renal rehabilitation program — as was its original intent.

Scapegoating Nephrologists? Or Instead Challenging them to Take Responsibility?
Blog posting by Dr. Peter Laird from HemoDoc.

Editor's note: I believe it is time to create a new medical specialist or specialty --- the renal replacement therapy coordinator who would initially lead the patient care team when the patient's goal was employment or rehabilitation. This role of an independent patient advocate is badly needed in today's system of care.

It is time to recognize that the vast majority of nephrologists do not have the training, expertise, or interest in creating programs that emphasize quality of life, employment and rehabilitation. It is simply outside the scope of their current practice. Instead of dragging nephrologists and LDOs reluctantly in this direction, we should encourage the many nephrology professionals (and experienced patients) who would embrace this new role enthusiastically. This would bring rapid, positive change to dialysis care. These experts could also provide badly needed feedback on improving dialysis care to CMS, Congress, medical and nursing organizations, as well as equipment designers and manufacturers.

If nephrologists aren't willing to perform these functions, they should at least be willing to call for the creation of a new professional position that will.

Judge Rules State Should Turn Over DaVita's Internal Investigation Evidence in Dialysis Deaths Case in Lufkin, TX
Articles from KTRE and The Lufkin Daily News.
Deceased Donor Transplantation Rates Declining in US
Article from Renal & Urology News. Abstract from The American Journal of Medicine.
Thousands of Seniors Lack Access to Lifesaving Organs, Despite Survival Benefit
Press release from Johns Hopkins Medicine.
Hold the Potassium
Posting from the Renal Fellow Network blog.
U.S. Diabetes Prevention Program Might Avert 885,000 Cases
Article from HealthDay.
Diabetes Patients Get Benefit from House Calls
Article from MedPage Today.

CJASN Express Abstracts:

Dosing of Renal Replacement Therapy in Acute Kidney Injury
Article in Press abstract from American Journal of Kidney Diseases.
Techniques of Extracorporeal Cytokine Removal: A Systematic Review of the Literature
Issue in Progress abstract from Blood Purification.
Decreased Paraoxonase One (PON One) Lactonase Activity in Hemodialyzed and Renal Transplanted Patients. A Novel Cardiovascular Biomarker in End-Stage Renal Disease
Advance Access abstract from NDT.
Treating the Obese Dialysis Patient: Challenges and Paradoxes
Early View abstract from Seminars in Dialysis.
Pesticides Fill Graveyards in Rural Villages (of El Salvador Due to Kidney Failure)
Pennsylvania Business Owner Indicted on Fraud Charges for Dialysis Patient Transportation by Ambulance
Jack Black To Attend Renal Teen Prom
AHRQ: 1 Percent of Population Tallies 21 Percent of Healthcare Expenses
News item from HFMA. Statistical brief (9-page pdf) from the Agency for Healthcare Research and Quality.
Patient Advocates Seek More Time To Weigh In On Essential Benefit Rules
News summary from Kaiser Health News.
FDA's December 2011 Safety Labeling Changes
40 medications, including heparin, had safety labeling changes.
Diabetes Drug Helps All Shed Pound
  Polio Breakthrough: India Marks Disease-Free Year
MedPAC Recommends 1.0% Update for ESRD Prospective Payment System
News item from AHANews.com
National Quality Forum Rejects 45% of Quality Measures that CMS is Considering
Posting from the Kaiser Health News blog.

See pages 75-77 of this (79-page pdf) for the recommendations for end-stage renal disease.
No Savings from Raising Medicare Age


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Thursday, Jan. 12

Judge Rules State Should Turn Over DaVita's Internal Investigation Evidence in Dialysis Deaths Case in Lufkin, TX
Article from KTRE.
Thousands of Seniors Lack Access to Lifesaving Organs, Despite Survival Benefit
Press release from Johns Hopkins Medicine.
 Jan. 12, 2012
US-Based DaVita Picks up Stake in NephroLife Care for India Entry
Articles from The Economic Times and LIivemint.
After Financial Incentives Are Introduced, Israel See Dramatic Increase in Organ Transplants in 2011
Article from Haaretz.com.
Kidney Disease Now 8th Leading Cause of Death in US
Article from AP. Report (69-page pdf) from the National Vital Statistics Reports.
In Minnesota, Emergency Funds for Chronic Dialysis Treatments Cut Off This Week
Article from Minnesota Public Radio.
Ironman Shad Ireland: An Iron Will
KidneyTalk podcast from Renal Support Network.
Evaluation of Objective and Subjective Indicators of Death in a Period of One Year in a Sample of Prevalent Patients under Regular Hemodialysis (in Brazil)
Provisional abstract and full-text article (13-page pdf) from BMC Research Notes.
A Dual-Chambered Hemodialyzer for Convection-Enhanced Hemodialysis
Early View abstract from Artificial Organs.

Articles in Press Abstracts from Journal of Nephrology:

Advance Access Abstracts from NDT:

Articles in Press Abstracts from the Journal of Vascular Access:

Urine Interleukin-18 and Cystatin-C As Biomarkers of Acute Kidney Injury in Critically ill Neonates
Free, full-text, Online First article from Pediatric Nephrology.
Higher Soda Tax Urged to Cut Obesity, Diabetes
Red Wine-Heart Research Slammed with Fraud Charges
Article from Reuters..
New Drug-Resistant Tuberculosis Threat Identified
Americans Living Longer, Report Finds
Covering Gym Fees Might Be Money Saver for Medicare
Raising Medicare's Eligibility Age Would Save Money, But Also Shift Costs


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Wednesday, Jan. 11

 Jan. 11, 2012
Newer Anemia Therapies
Posting from the eAJKD blog.
First Do no Harm: The Living Renal Donor Dilemma - Dr. Brenda Mayne's Story
Blog posting by Dr. Peter Laird from HemoDoc.
Complex Patients Benefit from Team Approach
Article from MedPage Today.
Combine Diabetes, Depression Care for Best Results
Article from MedPage Today. Related HealthDay story:

- Diabetes Takes a Toll on Lifetime Earnings
Weight Loss No Solution for Preventing Diabetes, Expert Says
Article from MedPage Today.
Masimo’s Prick-Free Pronto-7 for Painless Hemoglobin Spot Checking
Article from MedGadget.
Too Much Vitamin D Could Be Harmful to Heart
Article from HealthDay.
Prognostic Value of Arterial Pulse Wave Velocity in Peritoneal Dialysis Patients
Issue in Progress abstract from American Journal of Nephrology.
Los Angeles Area Teens With Kidney Problems Getting A Dream Prom
Video from CBS Los Angeles.
Hormone Helps Obese Shed Weight: Study
Certain Diabetes Drugs Might Aid Weight Loss
OIC Ships 6000 Hemodialysis Filters to Gaza
New Fibrosis Classification Improves Accuracy of Diagnosis in Hepatitis C
One in Six Americans Binge Drink: CDC
Mid-career Surgeons 'Are Safest'
Measuring Quality: 368 New Ideas For 2012


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Tuesday, Jan. 10