House Ways and Means Committee Approves Dialysis Patient Access To Integrated care, Empowerment, Nephrologists, and Treatment (PATIENTS) Demonstration Act - Update from Committee on Ways and Means. (H.R. 5942) - September 8, 2016

With Chronic Illness, You Are Your Own Best Friend - Article from Kaiser Health News. - September 7, 2016

Intensive Type 2 Diabetes Treatment Can Extend Survival: Study - Article from HealthDay. - September 7, 2016

Impact of the Use of Antidiabetic Drugs on Survival of Diabetic Dialysis Patients: a Five Year Retrospective Cohort Study in Taiwan - First Online abstract from Clinical and Experimental Nephrology. - September 6, 2016

Charitable Assistance: The New 'Pre-Existing Condition' - Article from The Hill. - September 1, 2016

Medicare Beneficiaries Face Growing Out-Of-Pocket Burden For Specialty Drugs While In Catastrophic Coverage Phase - Abstract from Health Affairs. - September 2016

Super-Secret KCER Not Providing Information or Updates on Florida Hurricane Situation - Home page of Kidney Community Emergency Response. -  - September 2016

Editor's note: Publically-funded, super-secret KCER continues its tradition of withholding information from patients and the public during disasters affecting dialysis centers.

Free, Full-Text Articles from American Journal Of Kidney Diseases - September 2016

• Establishing Evidence for the Future of Kidney Disease Education
• Patient Education and Choice of Peritoneal Dialysis

Applying Effective Teaching and Learning Techniques to Nephrology Education - Free, Full-Text, Advance Access Articles from Clinical Kidney Journal - August 31, 2016

Myths in Peritoneal Dialysis - Published Ahead-of-Print Abstracts from Current Opinion in Nephrology and Hypertension - August 31, 2016

Hillary Clinton Reveals Mental Health Plan That Taps Telehealth for Care Coordination - Article from Healthcare IT News. - August 30, 2016

JAMA Patient Page: Planning to Return Home After Surgery - Free, Full-Text Article from the Journal of the American Medical Association - August 30, 2016

Dialysis Patient Perspectives on CKD Advocacy: A Semistructured Interview Study - (12-page pdf) Full-text Article in Press and supplement (12-page pdf) from American Journal of Kidney Diseases via Home Dialyzers United. - August 24, 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. - August 24, 2016
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.

New Oral Diabetes Drugs May Also Protect Patients' Kidney Health - Press release and free, Open Access, JASN Express article from the American Society of Nephrology.- August 18, 2016

Patient Rights, Third-Party Payments and the CMS Request for Information - News release from the American Kidney Fund. - August 19, 2016

CMS Focuses on Provider Steering of Medicare- and Medicaid-Eligible People to Marketplaces - Posting from Health Affairs Blog. - August 19, 2016
"The tone of the request (for comments) strongly suggests that CMS disapproves of these practices and may take further action in the near future to discourage them. Indeed, the request for information is so strongly and negatively worded that it, together with the letters sent to dialysis facilities, is likely to have a distinct deterrent effect regardless of any further actions that CMS takes."

Editor's note: This is the best summary to date.

Expect a lot of crocodile tears from the for-profit providers, their surrogates, and the insurance companies in the coming comments. All these business interests will pontificate on their deep concern for these "sick and vulnerable patients."

Some dialysis providers are also trying to push dialysis patients into Medicare Advantage plans in order to increase their profits, despite many "disadvantages" for the patients. See this Aug. 4 posting in the KidneyViews blog.

Such Medicare Advantage legislation, entitled the ESRD Choice Act, is working its way through Congress. It is supported by Dialysis Patient Citizens, which was founded as DaVita Patient Citizens.

U.S. dialysis care is the most junk-bond-driven field of medicine, with most nephrologists entangled in a stagnant system of care that must service hundreds of millions of junk-bond debt. In these for-profit, high-risk, economic arrangements, who are the patients' advocates? The financiers' interests come first, the business executives' needs second, the nephrologists' interests come third, (insert DaVita employees here), and the patients' needs are sacrificed first and always come last.

‘Medical Tourism’ On The Rise: 1.4M Expected To Travel Outside U.S. For Health Care - News brief from Kaiser Health News. - August 18, 2016

Louisiana Disaster Recovery - Photographs from Fresenius Medical Care. - August 17, 2016

A Self-Serve Dialysis Machine May Be Coming Home With You - Article from Bloomberg Businessweek. - August 17, 2016

Is It a Medical Emergency? - KidneyTalk podcast from Renal Support Network.- August 16, 2016

Nine Louisiana Dialysis Centers Closed Due to Flooding - Link to Excel file from ESRD Network 13 (last update 8/15). Closed facilities listed:

• FMCNA - BAKER
• DAVITA EAST BATON ROUGE
• DAVITA - MID CITY DIALYSIS (Baton Rouge)
• DSI - DENHAM SPRINGS
• FMCNA - DENHAM SPRINGS
• DAVITA - YOUNGSVILLE DX (Lafayette)
• MORGAN CITY DIALYSIS CTR
• FMCNA - ASCENSION (Prairieville)
• DAVITA - WALKER DIALYSIS

The Greatest Potassium Lecture Ever — Parts 1, 2 and 3 - Lectures from Oakland University William Beaumont School of Medicine by Joel Topf, MD via the Precious Bodily Fluids blog. - August 10, 2016

Coping with Chronic Kidney Disease: “What Are Your Goals?” - Posting from the KidneyViews blog. - August 11, 2016

Dialysis Patient Perspectives on CKD Advocacy: A Semistructured Interview Study - Articles in Press Abstracts from American Journal of Kidney Diseases - June 18, 2016

ChoosingDialysis - "Empowering patients on choices for renal replacement therapy" 

Chronic Kidney Disease patient page from the Journal of the American Medical Association. - May 24/31, 2016

The Greatest Potassium Lecture Ever — Parts 1, 2 and 3 - Lectures from Oakland University William Beaumont School of Medicine by Joel Topf, MD via the Precious Bodily Fluids blog. - August 2016

Short How-To Recipe Videos Launch for Kidney Disease and Dialysis Patients - from DaVita Kidney Care