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  Aug. 26, 2016
Dialysis in the United States: How Do We Compare With Other Countries?
(Registration required, but free.) Berns on Nephrology video blog via Medscape Nephrology. Abstract from The Lancet.

Editor's note: Like it or not, the de facto leaders of U.S. dialysis care are the chief medical officers of the two largest for-profit dialysis providers, Drs. Franklin Maddux and Allen Nissenson. They have the onus of practicing medicine in corporations that must service hundreds of millions of junk-bond debt and efficiently utilize existing infrastructure. This reality will continue to push most patients into treatment regimens that virtually no nephrologists would choose for themselves.

What is basically wrong with U.S. dialysis care is its perverse financial incentives. U.S. nephrology embraced junk-bond financing of dialysis facility acquisitions, with many prominent U.S. nephrologists becoming multimillionaires. In light of international comparisons, the longer time that the American Society of Nephrology and the Renal Physicians Association wait to address these economic issues, the more harm they are doing to patients. Unfortunately, we will likely have to wait for this generation of wealthy and influential nephrologists to retire before any meaningful discussions can occur about the extent of the damage their actions caused to patients.

But all is not lost.

U.S. research nephrologists have focused on a "sick patient" model of care since the mid-1970s, putting nearly all their efforts into reducing mortality and hospitalizations. The ESRD QIP program, ESCOs, and integrated care models are all extensions of that sick patient model. Progress has been slow, with improvements in dialysis outcomes ─ and especially quality of life ─ lagging far behind other fields of medicine.

Before 1972, U.S. nephrology had a "well patient" model of care. It was also a time of rapid innovations that did not require randomized controlled trials. A strong financial incentive to restore an integrated well patient model could turn the for-profit corporations into innovators and real patient advocates. Extending the private insurance period for employed dialysis patients, in some regulated form, would drive changes in both their treatment regimens and infrastructure to benefit all patients.
Baxter and Satellite Healthcare Partner to Bring Innovative Dialysis Care to More Patients
Baxter press release.
FDA Hits Amgen with Rejection for Next-Gen Dialysis Med
Article from FierceBiotech. Amgen press release.
Nephros Announces Agreement to Initiate Hemodiafiltration Treatment at Vanderbilt Dialysis Clinic
Press release.
Free, Full-Text, Issue-In-Progress Articles from Blood Purification:
Community Acquired Acute Kidney Injury: a Challenge and Opportunity for Primary Care in Kidney Health
Free, full-text, review article from Nephrology.
Early View Abstracts from Seminars In Dialysis:
Early View Abstracts from American Journal of Transplantation:
Chloride Content of Solutions Used for Regional Citrate Anticoagulation Might Be Responsible for Blunting Correction of Metabolic Acidosis during Continuous Venovenous Hemofiltration
Free, full-text, Open Access article from BMC Nephrology.
Fibroblast Growth Factor 23 and Risk of CKD Progression in Children
CJASN Express abstract.
Accepted Articles Abstracts from Nephrology:
Public Health Researchers Develop Model to Predict Sudden Cardiac Death
Press releases from Emory Health Sciences and University of Pennsylvania School of Medicine. Published Ahead of Print abstract from Circulation.
FDA Issues Safety Recommendations for Programmable Syringe Pumps
News brief from AHANewsNow. FDA safety communication.
New Method Creates Endless Supply of Kidney Precursor Cells
Press release from the Salk Institute.
Louisiana Disaster Recovery
Photographs from Fresenius Medical Care.
Something to Think about: the Enemy of Compassion Is…
Article from the Mayo Clinic.

ACA Accountable Care Organization Initiatives: Physicians and Health Care Providers Continue to Improve Quality of Care, Lower Costs
CMS press release.

HHS: Medicaid Expansion Helped Lower ACA Premiums by 7%
News brief from Healthcare DIVE.

Previous News Stories
Why U.S. Dialysis Care Has Been Stagnant
Understanding Tassin
Nephrologists Can't Have It Both Ways (2015)
Ten Issues Nephrologists Do Not Want To Discuss with Dialysis Patients (2014)
The Missing Half of Excellence in
Dialysis Care 2013)
Human-Centered Care (2013)
Fix Dialysis
Boston ESRD Conference (2009)
New Views (2008)
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