Sunday, December 29, 2013

New Years Resolutions

Working Together

From WXYZ.com, ABC affiliate Detroit, MI, By: Smita Kalokhe


The Simon sisters each had 50 percent chance of having a life-threatening genetic disease. When three of the five women realized they had it, the other two sisters offered them the gift of life.

Kathie Wing, Beth Skorupski and Mary Simon were all diagnosed with polycystic kidney disease 25 years ago. Their two youngest sisters, Joan and Toni, didn't get the disease.

"This is a genetic disease that is passed down from parents," Dr. David Butcher, a transplant nephrologist at St. John Hospital, said. "(There is a) 50 percent chance of getting it."

"The minute I saw those cysts on the ultrasound, I knew. You could see them," remembered Kathie.

Kathie received a kidney from Joan 9 years ago.

The conditions for Beth and Mary both worsened. "We were kind of neck and neck as to who might need a kidney next," Mary told Action News.

Two years ago, Beth beat Mary to the need. She received the gift of life from Toni.

"I thought, 'Ok, I know I need this kidney now. Things are at a certain point, but what's Mary going to do?" remembered Beth.

The sisters banned together, writing letters to friends and relatives asking for a kidney donation for Mary.[Read more]


From Daily Herald, Geneva, IL, By Susan Sarkauskas


Rachel Duff, gave longtime friend Mandi Davis a kidney in November. It wasn't a direct donation, however, because Duff's kidney wasn't a match for Davis. Instead, they took part in a six-person transplant chain.


What's the best present your best friend ever gave you?

Few can match what Rachel Duff of Geneva gave Mandi Davis in November: A kidney. In a roundabout way.

Duff took a chance on giving a kidney to a stranger, trusting that a kidney transplant chain would work out and her friend would wake up from surgery with a new lease on life from somebody's else's kidney.

The story of the Nov. 21 operations at Northwestern Memorial Hospital in Chicago, in which Davis and two other people received new kidneys, started almost 20 years ago, when Duff and Davis, now 25, met at Harrison Street Elementary School in Geneva.

"Were we in Daisies (Scouts) together," Davis said.

Duff's mom was the troop leader. The girls and their mothers became friends, and even closer a few years later when the families ended up living on the same street. Davis recalled crashing her bicycle at Duff's house, and exploits such as eating cat food to see what it was like. "So we had a really funny friendship," she said.

Davis was being tested annually, as she had since her kindergarten physical, for kidney function. Doctors thought she had a benign condition, basement membrane glomerulonephritis. She took medication but didn't worry.

But then her lab work changed in 2010. A subsequent biopsy showed she had something else: Alport syndrome, a progressive genetic condition.

"So I'm a mutant," Davis said, laughing.

Nobody else in her family had the disorder or the genetic markers. She changed medication and knew that she might need a transplant one day.

"Maybe when I'm 50 or 60," she thought.

Davis left in August 2011 to study in Ecuador. But her condition worsened rapidly. Doctors told her she would need a transplant by age 35 at the latest, and that she should start arranging for one immediately, as it can take years to get a kidney from a deceased person.

By fall 2012, her condition was bad enough she had to start dialysis to remove toxins from her blood.

Transplant-wise, she ran into obstacles. Her only sibling, a brother, didn't share her blood type, and her parents weren't eligible. Lots of friends were tested but didn't match. Duff's mom matched but was deemed too old to give a kidney to the younger woman.

Duff was the only one to agree to a swap. [Read more]


From ECMPostReview.com, Minnesota, By Derrick Knutson

Giving the gift of life

Former student donates kidney to retired NB teacher

Many people can think of a favorite teacher or two they had during their elementary through high school years.

Few can say they donated a kidney to that teacher, though.

Kevin Noyes, a 1985 graduate of North Branch Area High School, forged a special relationship with Marlin Ness, a high school mathematics teacher who taught for 34 years in the district before retiring in 1997, while Noyes was growing up in the Almelund area.

He knew Marlin Ness well before becoming his student as a high school freshman.

Noyes and Marlin Ness’ son, Eric Ness, have been good friends since third grade.

The Nesses have been like a second family to Noyes for about 30 years.

“We were at our farmhouse many nights with the kids,” Marlin Ness said, noting that Noyes’ home was about 3 miles from the Ness’ house.

PKD diagnosis

During a baseline physical examination in 2004, Marlin Ness’ physician noticed something concerning: One of his kidneys was larger than it should have been.

“They couldn’t quite figure it out,” he said. “They just watched me for years, and then they finally said (in 2011), ‘You have polycystic kidney disease.’”

PKD is a disorder in which clusters of cysts develop primarily within a person’s kidneys. Cysts are noncancerous round sacs containing water-like fluid.

Over time, the disease diminishes the kidneys’ ability to filter waste out of person’s bloodstream, and some of those afflicted with the disorder experience complete kidney failure and have to go on dialysis.

PKD affects thousands of people in the United States and millions worldwide, according to the PKD Foundation.

Anne Petersen, a donor family liaison with American Donor Services, citing information from the American Kidney Fund, said about 18 people a day on donor lists die while waiting for organ transplants, and many of those are waiting for kidneys.

Like many patients waiting for kidneys, Ness eventually had to go on dialysis, but by that point, he knew he’d be receiving a kidney from Noyes.

However, he didn’t know initially that Noyes wanted to give his kidney to him.

Without Ness knowing it, Noyes went to be tested and found out he was a match. [ Read more]


From Mirror, United Kingdom, by Steve White


Helen Cavanagh, 52, is giving the ultimate Christmas gift to workmate and friend Julie Rogers

Selfless banker Helen Cavanagh is giving a workmate the ultimate Christmas present – one of her kidneys.

The 51-year-old Royal Bank of Scotland project manager goes into hospital with Julie Rogers, 45, today for the eight-hour op.

Julie, who had her kidneys removed in 2011, said: “It’s the gift of life. I couldn’t believe it, when Helen considered it.

“I was gobsmacked.”

Mum-of-two Julie, from Hindley, Lancs, has ­polycystic kidney disease – which killed her grandfather and two aunts.

Her mother, sister and daughters also have the hereditary condition so no family member could donate.

Julie’s kidneys grew so large that people thought she was pregnant and she has needed three five-hour dialysis sessions a week to keep her alive.

She said: “People last around five years on dialysis, I’m on my third.” [Read more]



Prevailing on Dialysis 

From Stornoway Gazette, United Kingdom

Renal patient forced to leave island
A Benbecula father will not be spending Christmas with his family this year due to a lack of access to lifesaving dialysis on the island.
The situation, which has been exasperated by a reduction in inter-island flights, means it is virtually impossible for him to return home.

Iain Macmillan (37) has a severe form of kidney disease which means he needs to have haemodialysis in hospital three times a week and cannot go without it for more than two days.

The service is not available at the Uist and Barra Hospital and trips home are complicated and expensive as he must also include detours to Stornoway to receive dialysis at Western Isles Hospital.

He now lives on the mainland because living at home is not an option, particularly as further cuts to travel links mean there are only flights to Stornoway three days a week which do not coincide with the three Renal Unit days.

Iain, however, longs to return to his home island where his family, including his 16 year old son live.

“It is shockingly difficult for me to get home,” he said. “The dialysis unit in Stornoway only offers dialysis on Mondays, Wednesday and Fridays but there are no flights to Stornoway from Benbecula on Mondays or Fridays, so I would be at the mercy of the ferries in order to get there. This isn’t always an option particularly in winter.”

He added: “The other option would have been to have dialysis in Inverness – but again the lack of flights mean that I wouldn’t be able to get home on a weekend after a dialysis session.


From Des Moines Register, Iowa, by Kyle Munson

39 Years on Dialysis: Small role in movie shines a bit of spotlight on Carlisle man

Shortly after John “Jack” Reynolds’ kidneys were crushed, so were his hopes.

He was just 4 years old in June 1956 when a farm accident nearly killed him: A 100-gallon barrel of water tumbled off a trailer, steamrolled over him and squashed his abdomen.

During Reynolds’ two months in the children’s hospital in Des Moines, singing cowboy and movie icon Roy Rogers happened to pay a visit.

The farm boy from rural Carlisle was wheeled into the playroom, still tethered to medical gear, yet eager to meet his childhood hero. But he got lost among the roomful of cute, sick kids.

Rogers “walked right by me, and he didn’t hardly look at me,” Reynolds said.

Reynolds, now 61, has survived on dialysis for 39 years — longer than anybody else in Iowa and probably many other states and countries.

Last year, he won his first paid, speaking acting role in Alexander Payne’s “Nebraska.” So bittersweet, belated recognition from Hollywood arrived, thanks to his unlikely showcase in a film that has become a top Oscar contender. [Read more]


From ANewsCafe.com, Redding, CA, by Candace Brown


Jody Cushman is battling tough odds. You’d never know it talking to her—she’s positive, matter-of-fact, warm and friendly. She makes the best of a limited lifestyle, devoting her time to family and friends.

For instance, she’s almost done with a remodeling project that will turn her spare bedroom into a walk-in closet. Not for her—for her friends.

“I miss out so much on girls’ nights, going out to dinner and on the town,” she said. “I want to entice my girls to get ready at my home.”

Cushman, 41, must hook herself up to a dialysis machine every night at 7 for 12 hours. The treatments keep her alive while she waits and hopes for a kidney match from a donor.

Diagnosed with diabetes at age 4, Redding resident Cushman said disease complications and an overuse of ibuprofen—which can damage kidneys—led to her first kidney failure and transplant at age 19. That kidney lasted 10 years before it, too, failed, forcing her back into dialysis for the past nine years.

“I need to say this,” she said. “This was brought on from diabetes and the fact that I wasn’t aware as much as I should have been. It wasn’t drug-induced. It wasn’t alcohol-induced. I’m not a smoker.” [Read more]


From Miami Herald, BY ALISSA GULIN

Dialysis centers face payment cuts

BALTIMORE -- Tracey Mooney is not looking forward to 2016.

As chief financial officer for an organization that operates dialysis centers across Maryland, she expects to have some tough decisions to make about two years from now, when her industry could face crippling reductions in Medicare payments.

There are about 115 dialysis centers across Maryland, but that number is in danger of dropping. The reason? A looming 9.4 percent reduction in Medicare reimbursement rates that providers and advocates worry will force some centers to close their doors, lay off workers or sacrifice quality of care. That would reduce the average per-patient payment from about $230 to $200.

The lower rates will likely take effect in 2016, unless the federal Centers for Medicare and Medicaid Services decides payments need to be increased. Providers say they're not optimistic.

Still, clinic operators like Mooney, who works for Independent Dialysis Foundation Inc., have braced themselves for worse.

CMS' original proposal, in July, called for the 9.4 percent cut in 2014. It was only in November, after intense resistance from the industry, that it announced rates would stay the same through 2015 and that the agency would re-evaluate payment levels in 2016.

The delay is a welcome reprieve, but spreading the cuts over several years will not make them any less painful; it will simply delay the consequences, providers and advocates said.

"At the end of the day, the phase-in is a blessing, but we're fearful of 2016," Mooney said.

Centers with higher percentages of Medicare patients will be the most likely to close their doors soon after the cut takes effect, said LeAnne Zumwalt, group vice president of Denver-based DaVita HealthCare Partners Inc., the second largest U.S. operator of dialysis centers, including the Downtown Dialysis Center in Baltimore. [Read more]

Read more here: http://www.miamiherald.com/2013/12/28/3840863/dialysis-centers-face-payment.html#storylink=cpy

Sunday, December 22, 2013

Family Sets British Kidney Transplant Record With Eleven Members

PKD & Kidney Transplant

From Daily Mail, United Kingdom, By MARTYN HALLE

Family sets British transplant record with ELEVEN members getting new kidneys as result of genetic condition

A family with 11 members who have each received a donor kidney has set a UK transplant record.

All of them suffer a genetic condition called Polycystic Kidney Disease (PKD).

Briggetta Greenaway, 55, who joined her brother, two uncles, three aunts and four cousins in the transplant club, said: ‘We are a unique family.’

Her uncle Bill Smith was the first family member to receive a transplant in 1963 in one of the UK’s first kidney transplants.

He died four months later of organ rejection, but four of his siblings had successful transplants between 1986 and 1998.

The disease is now into the third generation of the family, with five of Briggetta’s nephews likely to need a transplant in the near future.

Briggetta, a care worker from Chesterfield, who received her transplant in 1999, said: ‘We have all said thank you for this gift of life by keeping ourselves fit and healthy.’

She has traced the disease back to her grandfather Will Smith, who died aged 50. All of his eight children had PKD. [Read more]


From WestRoxburyPatch.com, by Matt Perkins (Editor), Boston, MA


A West Roxbury family has been steadily raising funds for their son since May, but is still welcoming support and donations.

Thomas Lane, of West Roxbury, was born on June 28, 2012 and is battling a rare kidney disease known as Autosomal Recessive Polycystic Kidney Disease (ARKPD), according to a GoFundMe.com page set up by his family.

"Thomas is our little hero and has quite the battle ahead of him," Marie McGillycuddy, Lane's aunt, wrote on the GoFundMe.com/ThomasFight page. "He has spent the majority of his life hospitalized and has undergone several major surgeries including nephrectomy, a tracheostomy and several feeding tube placements. Currently Thomas relies on a ventilator 24 hours a day in order to breathe, due to lung complications. Unfortunately Thomas also suffers from Caroli Syndrome, a cystic disease of the liver which affects 1 in 1 million people."

A Facebook page has also been set up to provide the family's supporters with updates. To donate to Lane's, visit the family's GoFundMe.com page here.


From 10News.com, , by Lindsay Shively, KSHB.com

Mo. woman campaigns via yard sign for life-saving kidney

KANSAS CITY, Mo. - You've seen plenty of yard signs for sales or campaigns, but one Missouri woman is using a yard sign to campaign for the fight of her life.

Amy Staples isn't worried about aging.

"Every birthday is great," she smiled. Every year is a blessing. She's battling polycystic kidney disease. It destroyed her kidneys and they had to be removed. She has been on dialysis for more than a decade. She spends more than 40 hours a week at home in a chair hooked up to her large dialysis machine.

"I consider it a full-time job," Amy said, shaking her head. She'd rather be working, but she recently had to stop working full time. Her condition just doesn't allow a lot of physical labor. The genetic disease has already killed her two sisters and one brother while they were waiting for a transplant on dialysis just like Amy.

She makes the two-hour drive to Kansas City with her husband regularly for pain management treatment. Between her type-O blood and complications from a blood infection, she is an incredibly difficult match for a donor. That's part of the reason she has been waiting so long, when the average wait time in the Kansas City area is about two years. [Read more]


Kidney Dialysis

From BizJournals.com, by Julie M. Donnelly Reporter- Boston Business Journal

More lawsuits target Fresenius over dialysis product

Two new lawsuits have been filed by kidney dialysis patients and their families, alleging that two Fresenius Medical Care North America products caused heart attacks. The two new cases, filed in federal court in Massachusetts on Dec. 16, are the latest in an avalanche of more than 300 lawsuits against the company, which has its U.S. headquarters in Waltham, Mass.

The two products were the subject of the most serious type of U.S. Food and Drug Administration recall in March of 2012.

Plaintiffs allege that Fresenius knew of the dangers of the product as early as 2005. They also point to an internal memo dated November 2011, in which Fresenius describes the results of an internal study and warns all Fresenius-owned or -operated dialysis centers to adjust the settings on dialysis machines to offset inappropriately high bicarbonate levels caused by the two products in questions, called Naturalyte and Granuflo. Naturalyte, a liquid, and Granuflo, a powder, are chemicals used to remove toxins in the blood during dialysis treatment. [Read more]


From Fiji Broadcasting Corporation

Group seeks govt subsidies for Dialysis treatment

A group of people suffering from renal failure have formed an organization to rally support and seek government subsidies for health care.
The Dialysis Assistance and Welfare Association are set to help people who can’t afford dialysis treatment.

Association Secretary Satya Lingam says they had their first audience with the Heath Minister in June this year.

“The Minister has assured us once the patients are given the medical identification card, they using those cards the patients will be able to purchase in the injections from the pharmacy at a subsidized rate, and also he has assured us the dialysis costs, the minister assured us they will be renegotiating with the Kidney Foundation so that the cost could come down, and five months have gone by we have not have seen any progress so far, so we have written a remainder.”

Satya Lingam says they weren’t expecting a six month delay, and even sent a letter to Dr. Neil Sharma reminding him of his assurances.

“Patients would be able to get the injection at $25, currently they are paying $60 and they wuld be getting it $25 from the government pharmacy in addition to that all other medication costs would be subsidized by the ministry of health, and that’s what the minister had agreed." [Read more]


Kidney Research

From ABC.net, Australia, by Samantha Donovan

Stem cell kidneys offer new hope

A team of Australian scientists led by the University of Queensland has successfully grown tiny kidneys from stem cells. It's hoped the breakthrough will eventually see new organs grown for people with chronic renal disease, cutting the huge demand for donor organs.

Australian researchers have grown a rudimentary kidney in the laboratory from human stem cells, an advance they say could lead to better ways of treating renal disease and testing drug safety.

Professor Melissa Little, from the University of Queensland's Institute for Molecular Bioscience, and colleagues, were able to guide embryonic stem cells to produce the cell types needed to 'self-organise' into a miniature kidney in a dish.

"It's much smaller than an adult kidney. It's essentially a little developing kidney," says Little.

The key to achieving this outcome was providing the cells with perfectly-calibrated combinations of molecules called growth factors.

By bathing the stem cells in particular concentrations of growth factors at particular times, they were able to guide them to grow and differentiate in a process that mimicked normal development.

"We had to walk the cells through all the steps they normally would take during development," says Little. "We used what normally happens in development to tell us what to add."

The researchers were initially aiming to coax the stem cells to produce just one type of kidney cell. But they were surprised to find that they had managed to form two key cell types, both of which are required to assemble a kidney. The research is published in the journal Nature Cell Biology. [Read more]



Drugs called ACE inhibitors and ARBs may help patients avoid dialysis as well, researchers say

MONDAY, Dec. 16, 2013 (HealthDay News) -- Drugs that help lower blood pressure may reduce the risk of early death for people with advanced kidney disease, a new study finds.

The drugs could also lower patients' odds of requiring dialysis, the researchers said.

The new study out of Taiwan focused on two types of high blood pressure drugs, angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin II receptor blockers (ARBs).

ACE inhibitors have long been a standby of blood pressure care, and include drugs such as Altace (ramipril), Vasotec (enalapril) and Lotensin (benazepril, among others). ARB medications are also used to lower blood pressure, and include medications such as Atacand (candesartan), Cozaar (losartan), and valsartan (Diovan, among others).

Both classes of drugs have been known to delay the progression of chronic kidney disease in patients with and without diabetes, the Taiwanese authors noted. However, most large studies of ACE inhibitors or ARBs have excluded patients with advanced chronic kidney disease, so it hasn't been known how these drugs affect this group of patients.

So, this new study included nearly 28,500 advanced chronic kidney disease patients with stable high blood pressure. During a follow-up of seven months, nearly 71 percent of the patients had to begin dialysis and 20 percent died before reaching that stage.

Patients who took an ACE inhibitor or an ARB had a 6 percent lower risk of dialysis or death than those who didn't take the drugs, according to the study published online Dec. 16 in the journal JAMA Internal Medicine. [Read more]



From HealthCanal.com

Dialysis is no laughing matter; however researchers are now asking if it should be

For 11,000 Australians kidney dialysis is not something to laugh about. However a good chuckle might well be the best thing for them.

In an Australian first, Deakin University’s Associate Professor Paul Bennett is leading a research team that is measuring the impact Laughter Yoga has on the health and wellbeing of patients on dialysis.

“Patients fronting up for dialysis for five hours a day, three times a week are often feeling down and experience lethargy, cramps, low blood pressure, anorexia and needle pain, so laughing is probably the last thing they feel like doing,” Associate Professor Bennett said.

“However Laughter Yoga has the potential to improve their mood and general wellbeing. Through this new study we will be measuring the impact Laughter Yoga has on the lung function, mood and well-being of patients undergoing treatment at the Monash Health’s Moorabbin Dialysis Centre.”

Laughter Yoga is based on the theory that voluntary laughter provides the same physiological and psychological benefits as spontaneous laughter including decreasing anxiety and improving mood and blood pressure. During the sessions patients are taken through 30 minutes of simulated laughing with controlled breathing and short exercises that involve clapping, neck and shoulder stretches, all designed for the limited mobility the patients have while hooked up to dialysis machines. [Read more]

Sunday, December 15, 2013

Kidney Transplant Issues Are Worldwide

Kidney Transplant

From The Times of India, Mumbai

New law essential for kidney patients’ woes: Eknath Khadse

Opposition leader Eknath Khadse, who recently travelled to Sri Lanka for a kidney transplant to avoid red tape back home, said a new legislation was essential to halt the harassment of patients. Khadse, encountered several procedural delays here though his wife was the donor.

Khadse, a chronic hypertension and diabetes patient, was diagnosed with a kidney problem over a month back. Against the normal creatinin level of 0.7 to 1.5, Khadse had a level of 5.5. "I was advised dialysis every alternate day. After two rounds, I found it was very tiring and I was completely exhausted," he said. A month and several dialysis rounds later, Khadse began to explore other treatment options. "I was told I could lead a near-normal life if I underwent a kidney transplant," he said.



"We found after medical examination that my wife's kidney was the best match," he added. But he was shocked by the procedural wrangles. "The minimum time required to complete formalities ranged between one to three months. At times, the state-level authorisation committee didn't meet for a month, so there was no decision. I also learnt of several patients dying due to the failure of the committee to take a decision," he said. Doctors advised him to perform the procedure abroad. "I was told if all documents were in order, the transplant could be over in less than three days," he said.

Khadse was told the procedural wrangles were owing to a Supreme Court order. "I feel officials are misleading people. My information is that the apex court prescribed stringent guidelines to curb the illegal kidney trade, it never wanted transplants to be halted. The CM should bring in a legislation, may be an ordinance, to simplify the procedure for kidney transplant and halt harassment of genuine patients and donors," he said.

Moreover, he found that the state-run JJ Hospital didn't even have a department of nephrology. "I am told the Centre has granted Rs 120 crore for the modernisation of JJ Hospital. It is unfortunate that it does not have basic facilities for kidney patients. I have taken it up with the chief minister," he said.

But Satish Pawar, director of health services, denied kidney transplant approvals took a long time. He said if the donor was a relative, then a decision is taken by a committee at the hospital's level. If the donor is not a relative, then the state-level authorisation committee decides on the issue. "It depends on documentation. If a specific case is brought to our notice, it will be probed," Pawar said. [Read more]


From Brooks Bulletin, Alberta, Canada, by Sandra M. Stanway


Ken Martin urges everyone to have the talk about organ donation.
For five years - during which time his hopes were raised by the prospect of four live donors - Martin has been on kidney dialysis.
For over three years he traveled from Brooks to Medicine Hat three times a week and just over two years ago he started home dialysis, three days a week, which is more convenient.
The master bedroom is neatly organized.
The machine stands ready for the night’s dialysis along with all the extras that are needed.
Spare medical material is stored in the closet in the master bedroom along with huge canisters to purify water.
Martin, 66, would love to remove the huge machine from his bedroom and give his wife back her closet.
That’s why he’s urging Albertans to have the talk about organ donation.
At the end of November the province announced that it will establish a donor registry.
A provincial agency in charge of human tissue and organ donations will be established by the summer. An online registry will follow in 2015.
“This online registry makes (sure) that you are a donor,” said Martin’s wife Georgina.
While the province gets organized Martin said now is the time to sit down with your family and let them know your wishes if you want to give life to someone who is waiting for an organ.
“People do not realize the situation that kidney patients are in,” Martin said.
He said many people sign the back of their driver’s licence agreeing to be a donor. However, if they haven’t told their family, the decision can be vetoed. [Read more]


From HuffingtonPost.com


Luna Coppola is a 32-year-old photojournalist who has been perpetually ill for the last decade. Diagnosed with Chronic Kidney Disease in 2004, she'd likely been living with the initially silent condition for longer, turning to dialysis when the disease reached its inevitable peak. It was then that she decided to document her battle, turning her lens onto herself to capture the exhaustion, self-consciousness, fear and hope she experienced while waiting for the only truly effective treatment for her sickness -- a kidney transplant.

"Symptoms become manifest when you are already in an advanced stage, when you cannot turn back, so you try to get on with it and adapt," Coppola wrote in a statement over email. {More story and images]



Kidney Care

From SBWire.com, Press Release

How to Improve Kidney Function in Polycystic Kidney Disease (PKD)

Healthy Kidney Publishing is back announcing that their program, “The All Natural Kidney Health & Kidney Function Restoration Program” can show anyone with Polycystic Kidney Disease (PKD) how to improve their kidney function. To learn more about the program and over 7 ways to improve kidney health click the link How To Improve Kidney Function

Polycystic Kidney Disease or PKD for short is one of the most dangerous kinds of kidney diseases. The reason is because there are no conventional or allopathic medical treatments that work to stop the disease process but now there is an option to help.

Below is an overview of what polycystic kidney disease is all about.

Polycystic is defined as ‘poly’ which means many and ‘cystic’ which means many cysts or sacs. With the definition, PKD means that there are many fluid-filled sacs found in the kidneys. This is a genetic disorder where many cysts are formed in the kidneys. The disease results inan enlarged kidney as caused by the fluid-filled cysts and destroys kidney function.

Who can be affected by Polycystic Kidney Disease (PKD)?

Polycystic Kidney Disease can happen to anyone and at any age. In terms of numbers, 5% of patients undergoing dialysis or transplant have PKD. PKD is inherited which means that the disease can be passed down from parents to their children.

Polycystic kidney disease (PKD) eventually lead to kidney failure caused by a combination of:

- Presence of scars in the normal support tissue in the kidney
- Compressing normal kidney tissue
- Pressure from expanding cysts

PKD has following health problems:

- Hypertension
- Urinary tract infection
- Kidney stones
- Kidney failure
- Kidney infection

There are Two Types of Polycystic Kidney Disease: Autosomal dominant PKD and Autosomal recessive PKD

1. Autosomal Recessive Polycystic Kidney Disease: This is a rare form of PKD where the symptoms appear in infants and young children. There is a 25% chance of inheriting the disease if each of the parents carries at least one copy of the defective disease gene. In a case where only one the parents carries the gene, there are no chances of inheriting ARPKD.
2. Autosomal Dominant Polycystic Kidney Disease: This most common among other kidney diseases which can affect 1 out a 1000 births. APKD signs and symptoms appear during middle age which is anywhere from 40 to 60 years old. Since the disease can be dominantly inherited, there is 50% percent chance that the parent can pass down the disease to his or her children. In a case where the disease was not passed on, offspring of the next generation may inherit APKD.

Polycystic Kidney Disease is diagnosed by different methods depending on what the doctor recommends. Below are the following methods:

- Blood tests
- Ultrasound
- X-ray
- CT Scan

How To Improve Kidney Function In PKD

Many people and even medical doctors reporting about their patients that after using The All Natural Kidney Health & Kidney Function Restoration Program so they a boost in kidney function.

Take 3 minutes to learn about this program, the many people it has helped and over 7 ways to improve and maintain kidney health, click the link below …
SIBU: Social Security Organisation (Socso) is spending more each year on members’ dialysis treatment, says Human Resources Minister Datuk Seri Richard Riot.

He said this when presenting two Socso’s haemodialysis machines to St John’s Ambulance Malaysia (Sibu Branch) in Jeriwit Road here yesterday. His text of speech was read by his political secretary Major (R) Peter Runin.

Riot said in 2012, Socso spent RM104.6 million on such assistance, an increase of 13 per cent from RM92.5 million in 2011.

“This year until November, Socso has spent RM96.3 million on assisting in dialysis treatment,” he said. According to him, Socso introduced dialysis treatment assistance to its members since 1999.

He said from Arterior Veneous Fistula (a preparation stage for the patients before the treatment), the assistance had extended to Continuous Ambulatory Partioneal Dialysis (CAPD) in 2003, and Erythropoietin (EPO) injection subsidies in 2009.

“In 2011, Socso provided subsidies for Immunosuppressant (Anti-Rejection) to patients who had undergone kidney replacement.

“Socso not only eased their financial burden, but encouraged them to go for kidney replacement to enable them to lead a normal life,” he said.

Currently, he said, Socso had selected 423 dialysis treatment centres as their panel centres nationwide. [Read more]



From The Times of India, Mumbai

Do you know anything about your kidneys?

Survey after survey has proven that Mumbaikars have weak kidneys. Here's a quiz to test how well you know the filtration units of your body

Last month, a news report had the BMC admit that Mumbai is suffering an 80 per cent shortage of dialysis beds. Several patients, unable to access dialysis, have succumbed to kidney failure.



With lifestyle disorders on the rise among urban Indians, it's especially important to take care of your kidneys (so what if you have a pair?). For that, you'll have to know the bean-shaped filters of your body inside out? Take our quiz to find out if you do:

1. Where are your kidneys located?
a) Front and upper section of your body
b) Front and lower section of your body
c) Lower section of your body, in the back
d) Lower section of your body, in front

Answer: C. Kidneys are located behind the abdominal cavity, above the waist. While their rear portion is covered by the ribs, the lower section is unprotected. If you place your hands on your hips, the position of your thumb indicates the position of the kidney.

2. Smoking affects the kidneys
a) True
b) False
Answer: A. The kidneys perform the essential function of keeping the blood in the body free of toxins. In fact, several heavy smokers suffer from renal cell carcinoma, says Dr Madan Bahadur, consultant nephrologist and transplant surgeon at Jaslok Hospital and Research Centre. Smoking also increases the deposition of cholesterol in large blood vessels, reducing blood supply to kidneys. This means oxygen levels in the kidneys drop, causing hypoxia, diminishing their ability to function optimally.

3. How much blood does a kidney filter every day?
a) 10 litres
b) 100 million litres
c) 180 litres
d) 100 litres
Answer: C. A healthy adult's kidneys filter about 180 litres of blood every day to remove toxic wastes.

4. What's a kidney-friendly combination?
a) Carrots and green beans
b) Pineapple, green peas and coffee
Answer: B. Pineapple, green beans and coffee are all low potassium foods. Potassium is a mineral present in most foods, and your kidneys are responsible for maintaining potassium levels in the body (healthy levels — 3.5 - 5.0 mEq/L). High levels can lead to a irregular heartbeat, and even a heart attack. [Read more]


From Republican Herald, Pottsville, PA, by STEPHEN J. PYTAK, Staff Writer

Center recognized for work with home dialysis patients

When John Thornton, 72, of Shenandoah, learned his kidneys were failing four and a half years ago, he faced a future filled with uncertainty.

"We weren't sure why they were failing. The doctors thought it might be because of the medication I was taking for a heart condition. But they're not sure," Thornton said Thursday.

He survives via a home dialysis method that uses tissues in his abdominal cavity as a filter. It's called peritoneal dialysis.

He braves the challenge with support from his wife, JoAnne, and the specialists at Fresenius Medical Care Dialysis Services of Pottsville Inc. at 278 Industrial Park Road, East Norwegian Township. They include Carla Pothering, a registered nurse who specialized in treating people who do their dialysis at home.

"They're terrific. I have no problems. They gave me good instructions on what to do. And if you follow their instructions, it seems everything works out all right," John Thornton said.

"If you need them, you can call them anytime," JoAnne Thornton said.

"JoAnne and I are a team," Pothering said.

"She is a wonderful person to work with. Wonderful. There's a good feeling between us. We can discuss things without holding back. We can give our opinions," JoAnne Thornton said of Pothering.

Earlier this year, the center was honored by Fresenius Medical Care with a "Center of Excellence Award" for "exceeding FMS Peritoneal Dialysis Quality Criteria," according to a framed certificate at the center.

It's based on meeting high quality targets associated with patient care, like anemia management, adequate dialysis and nutritional status, Pothering said.

"I've been here 17 years, and this is the first time we've received an honor like that," Pothering said Thursday.

This is the first time the clinic has received the award because it just became eligible for it in 2012. Clinics must have more than 10 patients to be eligible, a Fresenius representative said last week.

"Today, we have 17 home dialysis patients who are between the ages of 26 and 83," Pothering said. [Read more]


From MarketWatch.com - Press Release

SCAN Health Plan-VillageHealth Rated #1 By Consumers in Treatment of Renal Dialysis Patients


LONG BEACH, Calif., Dec 09, 2013 (BUSINESS WIRE) -- SCAN Health Plan announced today that its chronic condition special needs plan (C-SNP) for individuals with end-stage renal disease received the highest patient satisfaction rating of any C-SNP in California. The plan - called VillageHealth(R) - is a joint partnership with DaVita(R), a division of DaVita HealthCare Partners Inc. DVA +0.18% and a leading provider of kidney care services. VillageHealth received a 92 percent satisfaction rating in Medicare's Consumer Assessment of Healthcare Providers and Systems (CAHPS) 2013 survey.* [Read more]



Kidney Disease Treatment

From MedPageToday, by Todd Neale, Senior Staff Writer


Specific low-density lipoprotein (LDL) cholesterol treatment targets were removed from guidelines on managing lipids in patients with chronic kidney disease (CKD) released by Kidney Disease: Improving Global Outcomes (KDIGO) last month.

Instead, the decision to initiate cholesterol-lowering treatment -- specifically statin therapy -- should be based on the absolute risk of coronary events, and evidence that a therapy will help lower that risk,Marcello Tonelli, MD, of the University of Alberta in Edmonton, and Christoph Wanner, MD, of the University Hospital of Würzburg in Germany wrote in a synopsis of the guidelines published online Monday in Annals of Internal Medicine. [Read more]



Helping Others

From WLTX.com, Columbia, SC - includes video

Campaign Kicks Off to Support Manning Mayor

Manning, SC (WLTX) - A statewide outreach campaign, has kicked off in order to support the mayor of Manning.

After suffering for many years with polycystic kidney disease, Mayor Julia Nelson learned late last month that her condition had worsened.

The serious nature of her diagnosis has put her in immediate need of a kidney transplant. Due to the genetic nature of the illness, none of Nelson's siblings are viable candidates for a kidney donation.

Community members can help support the campaign by becoming a kidney donation candidate or by making a monetary donation to the Nelson Transplant Fund at any local NBSC bank.


From Mooresville Tribune, North Carolina

Iredell Community Foundation awards grants to 23 agencies

In November, the Iredell County Community Foundation distributed grants totaling $88,000 to twenty-three Iredell area nonprofit organizations. Recently, the Board of Trustees met with the recipients to recognize their important work in the community.

The 2013 grant recipients include:

• $4,000 to Iredell Kidney Dialysis Kidney Organization, Inc. to provide hemodialysis patients transportation to their dialysis appointments. [Read more]



From WJHG.com, NBC affiliate Panama City, Florida - includes video


A local man in need of a kidney transplant is spreading awareness by holding a benefit concert .
The Golden Rose Band hosted the fundraiser benefit for Stevan McInturff Saturday at the Parker Community Center.
Six months ago, McInturff went to the eye doctor for a routine check-up.
Doctors said his blood pressure was dangerously high and he was sent to the emergency room.
A short time later he was diagnosed with renal failure.
He was put on kidney dialysis and now he's needs a kidney transplant.
McInturff hopes his story will motivate others to see their doctors routinely.
"The change in life. The feelings at first like your dreams have all been crushed any futures. And then you come tor realize there's a way around that. In time you can heal," said McInturff.
Organizers hope to raise $5,000 for McInturff's medical bills.
The estimated cost for the entire operation is $120,000.
To donate, call 850-381-6237.



From Daily Mercury, Mackay, Queensland, Australia, by Megan Hughes

Pair have helped people with kidney disease for 20 year

LOCAL legends Herb St Pierre and Heather Miles have helped people suffering from kidney disease and their carers for 20 years.

Both have had family members affected by kidney failure, and they recognised a need for a support group in the region.

"When my husband needed dialysis, there was no support for partners and families," Mrs Miles said.

"It's good for partners and friends going through this to help them deal with it."

A renal dialysis unit opened at the Gladstone Hospital early last year allowing patients to receive treatment.

"Originally we had to drive to Rockhampton for dialysis," Mr St Pierre said.

"We finally got one chair here and then one of the gas companies helped fund it and it increased in size."

The team provides support and has also done fundraising projects over the years.

One project in particular shows just how much support this team is willing to give.

During the floods last January, a patient living in a remote area north of Rockhampton had to relocate to receive regular treatment.

Mr St Pierre and Mrs Miles raised enough money to pay for his living costs while he was receiving treatment.

The team also sponsor athletes who have undergone transplant surgery to go to the World and Australian Transplant games.

Regional areas have a higher prevalence of kidney disease, compared to urban areas in Australia, and research shows that men are more likely to have kidney problems than women, according to the Australian Institute of Health and Welfare.

Saturday, December 7, 2013

Dialysis Cost Questions, Challenges & Opportunities

Kidney Dialysis Costs

From nephrologynews.com, by Mark E. Neumann

CMS retains 12% cut in drug payments for ESRD care, approves new QIP measures

The Centers for Medicare and Medicaid Services issued its much-anticipated final rule Nov. 22 that updates 2014 payment rates for dialysis facilities paid under the end-stage renal disease Prospective Payment System (PPS). The agency also approved final changes to the ESRD Quality Incentive Program for performance year 2014, which will impact dialysis clinic payments in 2016.

Despite more than 1,000 comments protesting the proposed cut by the dialysis industry, patients, renal association groups, and even members of Congress, the agency decided to keep a 12% reduction in the drug utilization adjustment to the base rate, but implement it over a three- to four-year transition period.

(Where Medicare and the ESRD Program are headed)

CMS released a proposed rule in July that called for a 12% reduction in payments for injectable drugs based on a 30%+ drop in utilization––primarily in the prescribing of anemia drugs––from 2007 to 2012. The agency proposed to temper the cut with a 2.6% payment increase for 2014 based on the annual Medicare market basket review of costs of providing care to dialysis patients.

Congress required CMS to implement a payment reduction as part of the American Taxpayer Relief Act passed by Congress in 2012, but Congress left it up to the agency to determine the amount of the cut.

CMS said it would implement the first portion of the cut in 2014––a 3.3% reduction to the drug payment adjustment––but dialysis clinics won’t see a change in the overall payment for patients for 2014 and 2015 because of other offsets, the agency said.

The cuts will still have an impact on the bottom line for dialysis clinics, said Kidney Care Council and Kidney Care Partners in prepared statements released on Friday in response to the final rule. “Today’s Medicare ruling substantially reduces funding needed for patient care and interferes with the ability of our physicians, nurses, and clinical teams to do the very best for their patients,” said KCC chairman Tom Weinberg. Ultimately, the payment cut of $29.93 per dialysis treatment “contradicts the unified voice of patients, clinicians, providers, facilities, and members of Congress to correct the total amount of the reduction” originally proposed in July, said Weinberg. “Phasing in a cut of this magnitude only delays the harm.” [Read more]


From MedPageToday.com, By David Pittman, Washington Correspondent, MedPage Today



WASHINGTON -- Medicare payments to dialysis facilities will remain flat next year, the Centers for Medicare and Medicaid Services (CMS) announced late Friday, almost 4 months after threatening a 9.4% cut.

The agency, however, will increase by 50% what it pays providers to train patients to do dialysis at home, much to the delight of home dialysis advocates. CMS increased by $16.72 the reimbursement per training session, to $50.16. The news came in the announcement of CMS' finalized 2014 end-stage renal disease prospective payment system.

Just 2% of patients currently administer dialysis treatments themselves at home, a method that's lower-cost than treatment in traditional centers.

"The payment for training is insufficient for the resources that are required," said Joe Turk, president of North American operations for NxStage Medical, a medical device company that focuses on end-stage renal disease. "The change CMS has made is certainly in the right direction, so we're pleased with that."

Turk, who spoke with MedPage Today in a phone interview, said few facilities offer training for home treatment -- just one in five. "One of the reasons why that's the case is that reimbursement for the training has been insufficient," he said.

Turk noted a study from the Journal of the American Society of Nephrology last year which found mortality dropped for patients receiving hemodialysis at home as opposed to an inpatient setting. He added most patients and physicians would opt for home treatment if they had the choice.

The training takes about 4 to 5 hours a day, 5 days a week, for 3 to 4 weeks, according to Kathe Lebeau, director of patient services and public policy at Northeast Kidney in Albany, N.Y. [Read more]


From OttawaCitizen.com, a blog posted by David Reeveley


City staff recommend continuing a grant program for people who use home dialysis machines. This was set up in 2007 for the benefit of a fairly small number of people who are on kidney dialysis but don’t have to go to hospital for the treatment. Something I didn’t know before the program was proposed is that dialysis uses a stunning amount of water, a cost that would be absorbed by a hospital if you were getting dialysis there but that can be a significant expense for someone getting it at home. An average of about $400 worth of water a year for each of the 16 or 17 people enrolled in the grant program over the last few years.

It costs the city little, on the order of $7,000 a year, but probably helps save a lot more than that in medical costs, so no wonder they’re recommending renewing the program, in a report to next week’s meeting of city council’s finance committee.

I’m struck by how interrelated so many things our governments do are. The health system sends dialysis patients home, which is good, but that creates unexpected burdens on their water bills, so the city government that supplies water gives them rebates.



Dialysis Treatments

From RenalBusiness.com

CERTAIN MEASURES CAN HELP PREDICT OLDER DIALYSIS PATIENTS' PROGNOSES

WASHINGTON—Simple measures of the severity of an older kidney failure patient’s illness when starting dialysis—such as whether dialysis was initiated in an inpatient setting, the length of the patient’s hospital stay, and the use of other life-sustaining procedures—can convey meaningful information about the patient’s prognosis, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). The information can help guide physicians as they determine the best care for patients on dialysis.

Little is known about the circumstances under which older adults with kidney failure initiate dialysis or about how these circumstances might affect patients’ outcomes. To investigate, Susan Wong, MD, University of Washington, Seattle, and her colleagues analyzed national registry data pertaining to 416,657 Medicare beneficiaries aged 67 years and older who initiated chronic dialysis between January 1995 and December 2008. The researchers looked at the relationship between health care intensity around the time of dialysis initiation and subsequent aspects of patients’ health.

“Our research sought to provide important information on patients’ anticipated illness trajectory that could assist providers and patients in formulating treatment decisions and setting realistic expectations for the future,” said Wong.

Among the major findings:
Most patients (64.5 percent) initiated dialysis in the hospital, including 36.6 percent who were hospitalized for two or more weeks and 7.4 percent who underwent one or more intensive procedures, including mechanical ventilation, feeding tube placement, and CPR. Also, the proportion of patients initiating chronic dialysis in the inpatient setting has been rising in recent years.
Compared with patients who initiated dialysis in the outpatient setting, those who received the highest intensity of care at dialysis initiation (those who were hospitalized for two or more weeks and received at least one intensive procedure) had shorter survival times (median 0.7 vs 2.1 years), spent a greater percentage of remaining follow-up time in the hospital (median 22.9 percent vs 3.1 percent), were more likely to undergo subsequent intensive procedures (44.9 percent vs 26.0 percent), and were less likely to have discontinued dialysis before death (19.1 percent vs 26.2 percent).

The findings indicate that most older adults initiate chronic dialysis in the hospital, and those who have a prolonged hospital stay and receive other forms of life support around the time of dialysis initiation have limited survival and more intensive use of subsequent healthcare. [Read more]


From The New York Times, By JUDITH GRAHAM


The population of people on dialysis is graying; adults aged 75 and older are the fastest growing group beginning this treatment. But often doctors don’t answer their key question: “How long can I expect to live?”

Researchers at Tufts University and the University of New Mexico underscored the disconnect in a recent review. Ninety-five percent of patients said they and their families want to be given information about life expectancy, the authors noted. But a 2010 survey cited in the study found that 90 percent of patients had never discussed the issue with their nephrologists.

The researchers called for doctors to explain prognosis to patients and undertake shared decision-making, assessing the benefits and burdens of treatment in light of a person’s values. That recommendation has also been adopted by the Renal Physicians Association and the American Society of Nephrology. But the advice is widely ignored in practice.

I interviewed several experts and reviewed almost two dozen scientific reports for some answers about the prognosis for older adults on dialysis.
Q.

What is known about life expectancy among older dialysis patients?
A.

Older people on dialysis have a significantly shortened life expectancy, compared with peers in their age group. This is especially true when they have multiple illnesses: up to one-third of older adults with severe kidney disease have four or more other ailments, such as diabetes, hypertension, heart disease or dementia. [Read more]

New approach spots deadly hormone imbalances in end-stage kidney disease patients

A new testing method can better detect potentially fatal hormone imbalances in patients with end-stage kidney disease, according to a recent study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).

At the end of 2009, more than 871,000 Americans were being treated for end-stage renal disease, according to the National Institutes of Health’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). These patients require dialysis or kidney transplants to stay alive. About 10 to 20 percent of patients with chronic kidney disease stage 5, or end-stage renal disease, die each year.

One key factor that contributes to the risk of death in this population is levels of parathyroid hormone, the hormone that makes calcium available in the blood for important body functions. When parathyroid hormone levels are too low or too high, it raises the mortality risk for patients with end-stage renal disease. [Read more]


From DDDMag.com, an advertisement


Velphoro (sucroferric oxyhydroxide) has received U.S. Food and Drug Administration (FDA) approval for the control of serum phosphorus levels in patients with Chronic Kidney Disease (CKD) on dialysis. Velphoro will be launched in the United States by Fresenius Medical Care North America in 2014.

Velphoro (previously known as PA21) is an iron-based, calcium-free, chewable phosphate binder. Approval in the United States was based on a pivotal Phase 3 study, which met its primary and secondary endpoints. The study demonstrated that Velphoro successfully controls hyperphosphatemia with fewer pills than sevelamer carbonate, the current standard of care in patients with CKD on dialysis. The average daily dose to control hyperphosphatemia was 3.3 pills per day after 52 weeks. [Read more]


An Alexandria couple is thankful for more time together now with the ability to perform dialysis treatments at home.

Jack Tomlin was diagnosed as a teenager with a chronic kidney condition in which large cysts develop on his kidneys and affect their functioning.

It’s a genetic disease he inherited from his father, who received two kidney transplants. Tomlin has been on the transplant list almost two years.

He requires hemodialysis to remove waste from his blood and began treatments in July, first in a hospital and then for six months at a local clinic.

The rigid schedule of four-hour treatments three times a week had him seeing more of the clinic than home. But that changed with the addition of a home hemodialysis machine.

“It’s changed our life dramatically,” Tomlin said. “One, I’m in complete control of my treatment.”

He and wife Patty set up and clean the machine each treatment, allowing them flexibility to set their own schedule and change it when something comes up — like Thanksgiving lunch at Tomlin’s kids’ school. [Read more]


From WickedLocal.com, Brookline, MA

Home dialysis program earns honors for Brookline residents

Brookline — A dialysis program staffed by two Brookline residents has won a national award.

On Oct. 27, Dialysis Clinic Inc. (DCI, http://dciinc.org/) announced that DCI Ball Square, in Somerville, had won DCI’s 2013 Darwin Peterson Award for its home dialysis program. This annual award goes to the home dialysis program with the highest overall quality throughout DCI. The Somerville program is regional, serving patients from throughout Eastern Massachusetts, and is one of the busiest home dialysis programs in greater Boston.

Lynda Parke, RD, and Eliza Vanderstar MSW, JD, are the dietitian and social worker for the program. Both are residents of Brookline.

Parke, a native of Ireland, has worked in dialysis for 18 years. Vanderstar, who received the 2006 Outstanding Nephrology Social Worker Award from the regional National Kidney Foundation affiliate for her work with kidney patients at Beth Israel Deaconess Medical Center, has been with DCI since 2006.



Dialysis Treatment Centers

From ModBee, Modesto, CA, by BY J.N. SBRANTI


MODESTO — The first building in the long-planned Bridges Business Park next to the Kaiser Permanente medical center is nearing completion.

The $3.6 million structure is about finished, and an estimated $1 million in interior work is planned to turn the 11,500-square-foot building into an outpatient dialysis center for those with kidney problems.

The business park, at Dale Road and Kiernan Avenue, was annexed into Modesto along with Kaiser in 2004. But about the time the property was ready for construction, the recession hit.

Park developer Ronald Malik is optimistic about attracting new companies there, now that the economy has improved.

“We have an enormous amount of interest,” Malik said about prospective businesses. “People are evaluating the market … and having a billion-dollar anchor in Kaiser is very helpful.” [Read more]


From Times of India, by Janani Sampath


CHENNAI: The long queues of patients with end-stage kidney problems in front of dialysis centres are a common sight almost all over the country. The Supreme Court in a recent order, based on a public interest writ petition, directed the Centre and the states to offer proper medical care for people suffering from renal diseases and kidney failure. But, little seems to have been done on the ground in this regard.

The situation in the city where two lakh patients suffer from chronic kidney problems is not very different, say health experts. Latha Kumaraswami, managing director of TANKER foundation which works to raise awareness on kidney ailments, says there is an abysmal lack of dialysis care in Chennai.



"For patients waiting for donors to undergo a kidney transplant, dialysis is the only option. There a lot of centres that have been set up recently, but still cover only 20% of the patients," she said. The equipment and its maintenance are very expensive and so the treatment cost is unaffordable to many, she added.

The city has nearly 18 dialysis units, including two corporation-run units that offer free or subsidized dialysis sessions at Rs 375 a session for people from economically backward sections. The centres become crucial given that a dialysis session at a private hospital costs Rs 800-Rs 1,900 and patients require 2-3 sessions a week. "In private hospitals the cost comes up to nearly Rs 20,000 a month," said Latha.

Though the city has 50 nephrologists in the government and private sector, there is a huge demand for dialysis centres, says TANKER foundation trustee Dr Georgi Abraham. "There is a pressing need for dialysis units in three-tier cities and towns. But considering the equipment cost, electricity and water needed for hemodialysis, the government should consider bringing in the peritoneal dialysis (home dialysis) option that is already successful in Thailand," he said. [Read more]


From Zawya.com, Jeddah, Saudi Arabia

Jeddah to have kidney treatment center soon


The Prince Abdul Majeed Center for the Treatment of Kidney Disease in Jeddah is about to be opened, said Sami Badawood, director-general of Health Affairs in Jeddah. "The equipment and medical supplies for dialysis treatment are currently being brought in," he said. The three-story center, which cost about SR28 million, has a capacity of 150 beds and can accommodate 900 patients. It includes 140 dialysis devices and provides medical, therapeutic, social and awareness services to patients with renal failure.
The center is located at King Fahd General Hospital in Jeddah, where 18 nephrology consultants, 35 resident physicians and specialists and 280 nurses work in 16 specialized clinics designed to receive and treat kidney disease patients daily. Badawood confirmed that the old center in Jeddah's Al-Baghdadiah District will be closed and its services will be directed to other health services. The center's workforce will be shifted to the new center, he added. The new center is expected to admit 30-40 patients in need of renal dialysis and other related services daily. [Read more]


From Virgin Islands Daily News, BY ALDETH LEWIN (DAILY NEWS STAFF) 


ST. THOMAS - The first private hemodialysis clinic has opened on St. Thomas, offering another option for patients struggling with kidney failure.

The Caribbean Kidney Center-St. Thomas, owned by Dr. Walter Gardiner, opened Monday and currently is serving four patients while it is waiting for certification by the Centers for Medicare and Medicaid Services.

Gardiner said he has notified CMS that the clinic is in operation, and now he has to wait for them to come do an unannounced site visit and inspection.

Until the clinic is certified, he is not allowed to charge Medicaid nad Medicare for services, which is why he has limited the patient load to four for now.

"We have to treat patients so we have a record," he said.

"We hope they come soon, and once they come and we're certified, we'll open the doors to everybody." [Read more]



Kidney Transplant Debate

From The Daily Pennsylvanian, by Brenda Wang

Penn prof proposes legalizing sale of kidneys

According to estimates, nearly 100,000 people in the United States are waiting for a donation


Imagine paying off student loans by selling a kidney.

Matthew Allen, a student at the Perelman School of Medicine, and Peter Reese, an assistant professor of medicine at Penn, are calling for a reassessment of the National Organ Transplant Act of 1984, which prohibits the buying and selling of human organs for transplantation. In a recent editorial in the Clinical Journal of the American Society of Nephrology, Allen and Reese suggest that a “limited, real-world trial” of payment for kidney donations should be allowed so that researchers can assess the effects of such a policy. [Read more]



PKD Fundraising

From AllFacebook.com, by Guest writer

How Facebook Can Help Nonprofits Raise Money And Awareness


Like most nonprofits, the PKD Foundation aims to raise awareness of the issue it seeks to solve. Greater awareness leads to greater interest from scientists, politicians, and potential donors in working for a cure.

Polycystic kidney disease — a condition that has no cure — is one of the world’s most common life-threatening genetic diseases, affecting thousands in America and millions worldwide, although few people have heard of it. Working with BLiNQ Media, the PKD Foundation held a social media campaign that resulted in raising that awareness very effectively. The campaign increased interaction with foundation content by 439 percent, with total reach — the number of people exposed to our message — skyrocketing by 1,158 percent.

BLiNQ promoted the PKD Foundation’s Facebook campaign throughout March — National Kidney Month — pushing daily page posts to our existing fan base, friends of fans, and people who had expressed interest in kidney issues. BLiNQ also used its proprietary algorithm to find other people who seemed likely to engage with the PKD Foundation’s message. Because of this, our circle of influence increased, and we reached new people with our message.

The campaign resulted in 16,000 clicks on PKD promoted posts, and more than 14,000 engagement actions with PKD Foundation content. The response was remarkable. While the average click-through rate for mobile Facebook ads is no more than 1.6 percent, depending on who’s measuring, our campaign’s average CTR was 5.1 percent. [Read more]

Sunday, November 24, 2013

Kidney Dialysis: Medicare Will Phase in Cuts

Kidney Dialysis Payment Challenge

From SacBee.com, Sacramento Bee, California, by Kidney Care Partners

Nation's Kidney Care Community Says Medicare Rule Goes Too Far, Cuts Too Deep

Coalition Concerned That Phase-In Will Not Mitigate Impact on Patient Access and Care Quality  

WASHINGTON, Nov. 23, 2013 /PRNewswire-USNewswire/ -- The nation's kidney care leaders today expressed disappointment that the Centers for Medicare and Medicaid Services' (CMS) decision to cut Medicare payments for dialysis by 12 percent – or nearly $30 per treatment – over three to four years will have a negative impact on vulnerable dialysis patients by threatening access to and limiting options for quality care.

The final Medicare rule does not change CMS' original proposal, issued in July, which also includes additional cuts of 12 percent.

According to Kidney Care Partners (KCP), a coalition of patients, physicians, nurses, providers, and manufacturers, the rule deals a significant blow to an already fragile system by ultimately reducing Medicare payments to a level that will not cover the cost of care for individuals on dialysis.

"Phasing in this cut does not solve the problem," said KCP Chairman Ron Kuerbitz. "Instead, it only delays the inevitable harm that will come as a result of failing to cover the cost of care. Simply put, this model is unsustainable."

As a result of the rule, KCP said, providers and physicians will face difficult choices regarding staffing, facility hours, quality improvement interventions, and ultimately whether an entire facility can be kept open to service a community. In turn, Medicare beneficiaries could face reduced access to care. [Read more]
Read more here: http://www.sacbee.com/2013/11/23/5939540/nations-kidney-care-community.html#storylink=cpy


Read more here: http://www.sacbee.com/2013/11/23/5939540/nations-kidney-care-community.html#storylink=cpy


Read more here: http://www.sacbee.com/2013/11/23/5939540/nations-kidney-care-community.html#storylink=cpy



From MedCityNews.com, by Reuters, 2013

Dialysis operators dodge proposed 9.4% rate cut from CMS

(Reuters) - Medicare, the U.S. government healthcare program for elderly and disabled people, will leave its overall reimbursement rates for kidney dialysis treatment unchanged for next year, and said it will take three to four years to implement a mandated adjustment to its base rates.

The 2014 payment rates are much less onerous than the 9.4 percent cut proposed by the agency in July.

The rates, announced on Friday by The Centers for Medicare and Medicaid Services (CMS), the federal agency that sets reimbursement rates for Medicare, come on top of a 2 percent reduction that kicked in earlier this year under automatic cuts to federal spending.

CMS said the final rule also finalized a 50 percent increase to home dialysis training payment adjustments. The agency said the rates reduce Medicare payments by 1.05 percent - the combined effects of an increase in the home health payment update percentage of 2.3 percent, offset by a decrease of 2.7 percent - the result of adjustments required by the Affordable Care Act - and a 0.6 percent decrease due to a refinement of the payment system.

Fresenius Medical Care AG, or FMC, and DaVita Healthcare Partners Inc are the largest dialysis providers in the United States.

FMC operates more than a third of the dialysis treatment centers in the United States and Medicare contracts account for about 30 percent of its revenues.

The industry had lobbied for more moderate cuts, arguing that lowering payments by 9.4 percent would force smaller operators out of business, hitting patient care mainly in rural areas.

The proposed reimbursement cuts for dialysis providers mainly reflect a drop in the use of the expensive hormone erythropoietin, or EPO, to treat anemia, a common side effect associated with dialysis.

Lower use of EPO came as a result of medical studies showing the dangers of overuse and after a new reimbursement regime was introduced in the U.S. that encouraged prudent use of EPO and more use of cheaper drugs that can partially substitute EPO.

FMC, indirectly controlled by a German charitable trust, derives about two-thirds of its total revenues from North America.

FMC launched a cost-cutting program at the beginning of the year in response to U.S. austerity measures, but it has not provided details.

(Reporting by Deena Beasley, additional reporting by Ludwig Burger; editing by G Crosse)


Kidney Donation Lessons

From NationalPost.com, by Robyn Urback, Canada Financial Post


When Canadians must resort to online ads to find themselves human organs for transplant, we might have a bit of a problem on our hands. Yet a Nova Scotia man took to online classifieds this month in a desperate attempt to find himself a new kidney. Ken Wilkie, who has polycystic kidney disease, posted an ad on Kijiji on November 7 under the title “Boost Your Karma.”

“I am a hard-working father of two, I don’t drink, smoke or do drugs,” Wilkie said in the post, “so I promise I will look after your kidney.” Wilkie received about 40 replies from people willing to get tested to see if they are a match before the ad was removed in accordance with the site’s terms of use.

Wilkie’s disease is genetic, meaning that his immediate family members are ineligible to donate. He did have a donor lined up, but tests revealed that the would-be donor had cervical cancer. Wilkie jokingly talked about putting an ad on Kijiji after receiving the news, and he decided later to follow through...

...In 2008, the Israeli Knesset passed new organ donation laws that gave transplant priority to patients who had signed their own donor cards. Living donors were also offered new compensation for lost wages and medical expenses. The change was accompanied by a massive public awareness campaign, which resulted in 70,000 new donors signing up in 10 weeks. According to Israel’s National Transplant Center, the number of transplants increased dramatically in 2011 — 68% over the previous year. That figure waned from 2011 to 2012, though Israel’s Health Minister Yael German is now pushing for the country to adopt an opt-out system.

Israel’s priority system should serve as a model to Canadian legislators in terms of exploring models beyond altruistic donation. Good karma is great, but a promise to jump the line should the potential donor become the recipient is even better — especially since Canada doesn’t grapple with the same sort of religious barriers to donation as does Israel. At the very least, it certainly beats Kijiji. [Read more]


PKD Research

From SceinceDaily.com

'Mini-Kidney' Structures Generated from Human Stem Cells for First Time

Diseases affecting the kidneys represent a major and unsolved health issue worldwide. The kidneys rarely recover function once they are damaged by disease, highlighting the urgent need for better knowledge of kidney development and physiology.

Now, a team of researchers led by scientists at the Salk Institute for Biological Studies has developed a novel platform to study kidney diseases, opening new avenues for the future application of regenerative medicine strategies to help restore kidney function.

For the first time, the Salk researchers have generated three-dimensional kidney structures from human stem cells, opening new avenues for studying the development and diseases of the kidneys and to the discovery of new drugs that target human kidney cells. The findings were reported November 17 in Nature Cell Biology.

Scientists had created precursors of kidney cells using stem cells as recently as this past summer, but the Salk team was the first to coax human stem cells into forming three-dimensional cellular structures similar to those found in our kidneys.

"Attempts to differentiate human stem cells into renal cells have had limited success," says senior study author Juan Carlos Izpisua Belmonte, a professor in Salk's Gene Expression Laboratory and holder of the Roger Guillemin Chair. "We have developed a simple and efficient method that allows for the differentiation of human stem cells into well-organized 3D structures of the ureteric bud (UB), which later develops into the collecting duct system."

The Salk findings demonstrate for the first time that pluripotent stem cells (PSCs) -- cells capable of differentiating into the many cells and tissue types that make up the body -- can made to develop into cells similar to those found in the ureteric bud, an early developmental structure of the kidneys, and then be further differentiated into three-dimensional structures in organ cultures. UB cells form the early stages of the human urinary and reproductive organs during development and later develop into a conduit for urine drainage from the kidneys. The scientists accomplished this with both human embryonic stem cells and induced pluripotent stem cells (iPSCs), human cells from the skin that have been reprogrammed into their pluripotent state. [Read more}



From HealthCanal.com, By Duke Medicine News and Communications - DURHAM, N.C

Early Data Show Potential for Investigational Bioengineered Vessel as Dialysis Graft

An investigational, man-made blood vessel used in vascular grafts for kidney dialysis patients may potentially show encouraging early results among study patients in Poland, according to preliminary data reported Wednesday by a researcher at Duke Medicine.

Presented at the American Heart Association Scientific Sessions meeting in Dallas, the early findings of this interim patient data track 28 hemodialysis patients who received grafts using the investigational bioengineered vessel during a multi-center study launched in Poland last December.

The investigational bioengineered blood vessel, designed to be the first off-the-shelf product incorporating human tissue in the bioengineering process, provided blood flow in 100 percent of the study patients, reported Jeffrey H. Lawson, M.D., Ph.D., professor of surgery and pathology at Duke University School of Medicine. Eight patients later lost blood flow, but it was restored with interventions in each case.

Lawson said there is a significant need for alternative types of vascular technology. Current synthetic vascular grafts used for hemodialysis access provide initial blood flood in less than 50 percent of patients at six months, and with secondaryinterventions the success rates rises to 77 percent, Lawson said.

Preliminary interim analysis of the investigational bioengineered vessel currently being used for dialysis among the Polish patients has resulted in no infections to date, no immune reactions and no sign of structural degeneration.

“These early data are very encouraging,” said Lawson, who performed the first U.S. implantation of the blood vessel in June in a patient with end-stage kidney disease. [Read more]