From Renal and Urology News, by Stephen Cho
Dialysis patients who live at high altitudes have a significantly reduced risk of mortality, according to a study published inHemodialysis International.
Kamyar Kalantar-Zadeh, MD, MPH, PhD, of the University of California Irvine Medical Center and colleagues studied a national cohort of 144,892 dialysis patients with a follow-up of 801 days to examine the connection between residential altitude and all-cause mortality in these patients.
All patients had stage 5 chronic kidney disease and were undergoing dialysis treatment from July 2001 to June 2006. The investigators compiled data from the U.S. Geological Survey to link residential zip codes with patient information.
In fully-adjusted analysis, the researchers found that high residential altitude, defined as 6000 feet or greater, was associated with a significant 8% reduction in all-cause mortality risk in dialysis patients compared with living at less than 250 feet.
“These results support previous findings, although the effect size we observed was smaller in comparison,” the authors noted.
Patients living in higher altitudes were more likely to be white, married, on peritoneal dialysis, and receiving catheter dialysis access, compared to those on lower altitudes (less than 250 feet). They also displayed higher hemoglobin and creatinine levels, but lower parathyroid hormone levels. [Read more]
From El Paso Times, El Paso, TX, By Victor R. Martinez
Informed Patience: 13 years of dialysis hones waiting game of El Paso woman on kidney donation list
El Pasoan Veronica Carroll sits patiently, three hours a day, three times a week.
Every Tuesday, Thursday and Saturday at 5 a.m. the medical staff at an East El Paso dialysis center connect her to a dialysis machine — artificial kidneys that perform most, but not all, kidney functions for patients who have permanent or temporary renal failure.
On one arm are two 15-gauge needles and a blood pressure cuff on the other.
The dialysis machines use hemodialysis to cleanse the blood and balance its constituents. With this process, the patient's blood is circulated through the machine where it is filtered and balanced for electrolytes, pH levels and fluid concentration before being returned to the patient.
Not a fun experience at all.
"It just drains you emotionally and physically," she said. "You're just so tired afterward. Some people feel really good and alive but most of us feel really tired to the point where we don't want to do anything. Sometimes we are even too tired to think."
Carroll has been on dialysis since 2001, the year her son Logan Perrine was born.
"I had very high blood pressure during the pregnancy which somehow caused my kidneys to fail," she said. "Now, I have to watch what I eat. I can't eat bananas, I can't have pizza or any dairy. We are really restricted on our liquid intake."
Despite 13 years of dialysis, it's still not easy for Carroll.
"To sit in a chair for as long as we do, it's difficult," she said. "Some people sit in that chair for four to five hours, three times a week. To just sit in that chair and not move your arm because you have 15-gauge needles in your arm, is not easy."
The anxiousness Carroll feels during treatment remains a constant.
"You want to get up and move so bad but you can't," she said. "You can take a nap but other machines will go off around you and wake you up because other patients are there. You do get to talk to other patients, which is nice and the techs and the nurses are very friendly but that's it."
Carroll is also waiting patiently for a kidney donation. [Read more]
From The Spec, Hamilton, Ontario, Canada, by Molly Hayes
Home dialysis is old hat for Ancaster granddad
After almost 15 years of practice, Bob Milne is a pro at dialysis.
In fact, at 90 years old, the Ancaster man just might be the oldest home-based hemodialysis patient in Ontario — or at least the oldest who self-administers their treatment.
"I'm something, aren't I?" Milne says with a chuckle.
When he was diagnosed with kidney failure in 1999, the St. Joseph's Healthcare Hamilton Kidney and Urinary Services team immediately got Milne and his wife, Ruth, involved in its home-based dialysis training program.
Now, a decade and a half later, they have the routine down pat.
Three days a week, Milne gets up at 5:30 a.m. to prep his machines for the four-hour treatment, which will cycle his blood through a filtering process, eliminating waste.
Next step is prepping the coffee, and finally, inserting the needles.
"I like to get it finished early," he says.
Even in the comfort of his own home, he admits dialyzing is no walk in the park. But it beats making the thrice-weekly drive to the Stoney Creek clinic — especially when the weather's bad.
Ruth, 83, his wife of 62 years, agrees.
Of the approximately 650 dialysis patients at St. Joe's, roughly 60 do their treatments at home. The flexibility is the main draw, says registered nurse Linda Mills.
"You can have a life without dialysis being your life," says Mills, who has worked with the Milnes since day one.
It's not a money-saving program for St. Joe's, she stresses. It's about providing patients with choices.
. Ruth says Mills is "our pet," but the family is close to the entire staff. All the nurses came out to a 90th birthday party for Milne, who says with a smile that he's not one for parties but didn't mind the nurses. [Read more]
From Digital Journal, Wellesley, MA, Press Release
BCC Research (http://www.bccresearch.com) reveals in its new report, Renal Dialysis Equipment: Technologies and Global Markets, the global dialysis equipment and accessories market is expected to grow to nearly $18.8 billion by 2018, with a five-year compound annual growth rate (CAGR) of 7%. Peritoneal dialysis, the fastest-growing segment, is moving at a significant 8.2% CAGR.
Dialysis equipment and accessories are used extensively in dialysis centers, hospitals, and home care settings for artificial renal replacement therapy of ESRD and acute kidney injury (AKI) patients. Peritoneal dialysis, the largest and fastest moving sector in this market, is expected to reach $5.4 billion in 2018, due to the rising cost pressures, and clinical evidence demonstrating its worth in improving quality of life.
The Hemodialysis (HD) equipment market, the second-largest and fastest-growing sector, is projected to reach nearly $2.4 billion by 2018 and register a CAGR of 7%.
"The HD market is expected to be saturated in Western countries by 2018," says BCC Research healthcare analyst Krishanu Bhattacharjee. "Growth is likely to be driven by the establishment of new dialysis centers and hospitals in emerging markets such as India, China, and Thailand. Market growth is also expected to be complemented by the launch and subsequent acceptance of cost-effective, portable HD equipment." [Read more]
From Business Day, Lagos, Nigeria, by Alexander Chiejina
Private dialysis business booms on renal disease upsurge
The growing prevalence of diabetes, hypertension and a large susceptible elderly population, are rapidly driving up the number of people developing end stage renal diseases (ESRD) in Nigeria, spurring an upsurge of new investments in dialysis business valued at $314 million (N54 billion).
The number of dialysis patients in Nigeria is estimated by experts at 50, 000 with 15, 000 patients developing kidney diseases annually. Demand for this healthcare portfolio is said to far outstrip supply, with only 76 dialysis units to serve the affected population size in Nigeria.
Private sector players operate only 34 of the dialysis centres, while government operates 42. Lagos, said to be Nigeria’s most populous state, with 22 million inhabitants, accounts for 20 dialysis units (with 15 privately run and 5 government run) besides the two kidney transplant units in Lagos State(1 private and 1 public).
While people with ESRD are required to undergo three dialysis sessions a week (each lasting between three and four hours) at a cost of between N25, 000 and N 30, 000 per session, this leaves several patients with high out-of-pocket payment for healthcare services and at the mercy of family and well wishers.
Experts say the number of sufferers, mostly middle-aged Nigerians, is alarming for a country which depends on its productive young and middle-aged for development.
Industry watchers say this situation undermines Nigeria’s quest to meet the 30 percent Universal Health Coverage target by 2015 which it set for itself, with the present health insurance cover able to serve only three to six dialysis sessions per individual, leaving the patient to pay for the remaining 30 sessions worth over N900, 000. [Read more]
From Record Online, Time Herald-Record, Hudson Valley, NY, By Beth Kalet
New York is 49th out of 50 states in organ donation
Here's a surprising fact: New York ranks 49th out of the 50 states in percentage of registered organ donors.
That's a situation the New York Organ Donor Network wants to change. "It's a shocking statistic, and we're not very happy about it," says Julia Rivera, the network's director of communications.
That's how Patricia Mayer Van Duser feels, too. Born and raised in Newburgh, Van Duser has been teaching fifth-grade at Fostertown Elementary School for more than 20 years. Since January 2013, she's been on the waiting list for a donor kidney.
A frustrating wait
Van Duser carries a beeper that will alert her as soon as a donor match has been made for her. When that happens, she and two other matches will have to hurry down to Columbia Presbyterian Hospital in New York City to see which one of them will receive a donor kidney.
Van Duser, who will turn 50 in May, is one of 10,000 New Yorkers waiting for an organ transplant today, according to the Donor Network. Nationwide, some 130,000 people are on waiting lists. A single donor has the potential to save up to eight lives, Rivera points out. And that's why it's so frustrating to her that more New Yorkers haven't signed up to save a life.
"The big deal here is that people don't understand that when you sign up on the registry, it simply provides your family an opportunity to know your wishes. It documents your decision so nobody can change that," Rivera says.
There are two easy ways to become a registered organ donor in New York. The state has recently simplified its donor registry that accompanies driver license applications and renewals. And, Donor Network has its own site: donatelifeny.org/hate-the-wait/
[Read more]
Neelie Kroes EU, Vice-President of the European Commission, responsible for the Digital Agenda, said: "mHealth is just one of the benefits of a Connected Continent – helping patients, doctors and carers take control, wherever they are. From simple apps which help you stick to your exercise regime – to monitoring tools for those on kidney dialysis. I am delighted that the EU is so committed to this fascinating area. The EU has already invested over €100 million, with about €95 million up for grabs over the next two years. And we are now consulting on how best to unlock the huge potential of mobile healthcare."
Four EU-funded projects making the most of mHealth 1. Patients with kidney failure to get a new lease of life with Nephron PlusChronic kidney disease will affect one in ten of us at some point in our lives. For those of us unfortunate enough to suffer renal failure, the health consequences can be disastrous and the treatments very complex. The @nephronplus project received €5 million of EU funding to improve the lives of patients by developing a wearable artificial kidney device, whose indications can be remotely monitored by patients on their smartphone, and by medical staff.
A more full and active life. "Continuous, 24/7 dialysis with a wearable device offers a smooth and uniform extraction of toxins over the day similar to the natural kidney. This improves the health condition tremendously and eliminates the 'after dialysis sickness syndrome' that many patients suffer from", explains Frank Simonis, technical manager of NEPHRON+. Constant remote monitoring of data is also a key feature of the system. Via a personal renal care app on their mobile device, patients will be able to consult and manage data, and include alarm settings. Their doctors will also be able to monitor the treatment, and remotely adapt it. According to Simonis "The NEPHRON+ system will make it possible for dialysis patients to lead a more full and active life." [Read more]
On April 9, the president of the American Society of Nephrology (ASN) urged Congress to boost scientific innovation in kidney research through a federal prize competition. In her testimony before the House Science, Space, and Technology Subcommittee on Research and Technology, ASN President Sharon M. Moe, MD, FASN, voiced support for federal prize competitions as a mechanism to incentivize new approaches to renal replacement therapy that could reduce escalating Medicare costs and improve care for the 450,000 Americans with kidney failure.
“I feel strongly that current scientific knowledge in the understanding of the kidney is at a level that makes such life-altering innovation a real possibility. I firmly believe American ingenuity is ready and willing to take this basic knowledge and turn it into a transformative, cost-saving technology that offers real hope for a better life to patients suffering through the current consequences of dialysis. Together, we can offer hope to the 20 million Americans with kidney disease who fear dialysis is in their future,” said Moe, who is a professor of medicine and director of the Division of Nephrology in the Department of Medicine at the Indiana University School of Medicine.
Her testimony at the Prizes to Spur Innovation and Technology Breakthroughs hearing highlights how a federal prize competition for kidney disease would mobilize the development of new tools to address one of the costliest health care challenges the U.S. government faces today.
Nearly 450,000 Americans with kidney failure rely on the Medicare End-Stage Renal Disease (ESRD) Program for lifesaving dialysis. The ESRD Program is the only federal health entitlement program that provides coverage regardless of age or disability. Caring for people with kidney failure costs Medicare nearly $35 billion annually. Patients with ESRD account for less than 1% of the Medicare population but their care constitutes 7% of the program’s budget. [Read more]
Poor quality of life may contribute to kidney disease progression
El Pasoan Veronica Carroll sits patiently, three hours a day, three times a week.
Every Tuesday, Thursday and Saturday at 5 a.m. the medical staff at an East El Paso dialysis center connect her to a dialysis machine — artificial kidneys that perform most, but not all, kidney functions for patients who have permanent or temporary renal failure.
On one arm are two 15-gauge needles and a blood pressure cuff on the other.
The dialysis machines use hemodialysis to cleanse the blood and balance its constituents. With this process, the patient's blood is circulated through the machine where it is filtered and balanced for electrolytes, pH levels and fluid concentration before being returned to the patient.
Not a fun experience at all.
"It just drains you emotionally and physically," she said. "You're just so tired afterward. Some people feel really good and alive but most of us feel really tired to the point where we don't want to do anything. Sometimes we are even too tired to think."
Carroll has been on dialysis since 2001, the year her son Logan Perrine was born.
"I had very high blood pressure during the pregnancy which somehow caused my kidneys to fail," she said. "Now, I have to watch what I eat. I can't eat bananas, I can't have pizza or any dairy. We are really restricted on our liquid intake."
Despite 13 years of dialysis, it's still not easy for Carroll.
"To sit in a chair for as long as we do, it's difficult," she said. "Some people sit in that chair for four to five hours, three times a week. To just sit in that chair and not move your arm because you have 15-gauge needles in your arm, is not easy."
The anxiousness Carroll feels during treatment remains a constant.
"You want to get up and move so bad but you can't," she said. "You can take a nap but other machines will go off around you and wake you up because other patients are there. You do get to talk to other patients, which is nice and the techs and the nurses are very friendly but that's it."
Carroll is also waiting patiently for a kidney donation. [Read more]
After almost 15 years of practice, Bob Milne is a pro at dialysis.
In fact, at 90 years old, the Ancaster man just might be the oldest home-based hemodialysis patient in Ontario — or at least the oldest who self-administers their treatment.
"I'm something, aren't I?" Milne says with a chuckle.
When he was diagnosed with kidney failure in 1999, the St. Joseph's Healthcare Hamilton Kidney and Urinary Services team immediately got Milne and his wife, Ruth, involved in its home-based dialysis training program.
Now, a decade and a half later, they have the routine down pat.
Three days a week, Milne gets up at 5:30 a.m. to prep his machines for the four-hour treatment, which will cycle his blood through a filtering process, eliminating waste.
Next step is prepping the coffee, and finally, inserting the needles.
"I like to get it finished early," he says.
Even in the comfort of his own home, he admits dialyzing is no walk in the park. But it beats making the thrice-weekly drive to the Stoney Creek clinic — especially when the weather's bad.
Ruth, 83, his wife of 62 years, agrees.
Of the approximately 650 dialysis patients at St. Joe's, roughly 60 do their treatments at home. The flexibility is the main draw, says registered nurse Linda Mills.
"You can have a life without dialysis being your life," says Mills, who has worked with the Milnes since day one.
It's not a money-saving program for St. Joe's, she stresses. It's about providing patients with choices.
. Ruth says Mills is "our pet," but the family is close to the entire staff. All the nurses came out to a 90th birthday party for Milne, who says with a smile that he's not one for parties but didn't mind the nurses. [Read more]
BCC Research (http://www.bccresearch.com) reveals in its new report, Renal Dialysis Equipment: Technologies and Global Markets, the global dialysis equipment and accessories market is expected to grow to nearly $18.8 billion by 2018, with a five-year compound annual growth rate (CAGR) of 7%. Peritoneal dialysis, the fastest-growing segment, is moving at a significant 8.2% CAGR.
Dialysis equipment and accessories are used extensively in dialysis centers, hospitals, and home care settings for artificial renal replacement therapy of ESRD and acute kidney injury (AKI) patients. Peritoneal dialysis, the largest and fastest moving sector in this market, is expected to reach $5.4 billion in 2018, due to the rising cost pressures, and clinical evidence demonstrating its worth in improving quality of life.
The Hemodialysis (HD) equipment market, the second-largest and fastest-growing sector, is projected to reach nearly $2.4 billion by 2018 and register a CAGR of 7%.
"The HD market is expected to be saturated in Western countries by 2018," says BCC Research healthcare analyst Krishanu Bhattacharjee. "Growth is likely to be driven by the establishment of new dialysis centers and hospitals in emerging markets such as India, China, and Thailand. Market growth is also expected to be complemented by the launch and subsequent acceptance of cost-effective, portable HD equipment." [Read more]
The growing prevalence of diabetes, hypertension and a large susceptible elderly population, are rapidly driving up the number of people developing end stage renal diseases (ESRD) in Nigeria, spurring an upsurge of new investments in dialysis business valued at $314 million (N54 billion).
The number of dialysis patients in Nigeria is estimated by experts at 50, 000 with 15, 000 patients developing kidney diseases annually. Demand for this healthcare portfolio is said to far outstrip supply, with only 76 dialysis units to serve the affected population size in Nigeria.
Private sector players operate only 34 of the dialysis centres, while government operates 42. Lagos, said to be Nigeria’s most populous state, with 22 million inhabitants, accounts for 20 dialysis units (with 15 privately run and 5 government run) besides the two kidney transplant units in Lagos State(1 private and 1 public).
While people with ESRD are required to undergo three dialysis sessions a week (each lasting between three and four hours) at a cost of between N25, 000 and N 30, 000 per session, this leaves several patients with high out-of-pocket payment for healthcare services and at the mercy of family and well wishers.
Experts say the number of sufferers, mostly middle-aged Nigerians, is alarming for a country which depends on its productive young and middle-aged for development.
Industry watchers say this situation undermines Nigeria’s quest to meet the 30 percent Universal Health Coverage target by 2015 which it set for itself, with the present health insurance cover able to serve only three to six dialysis sessions per individual, leaving the patient to pay for the remaining 30 sessions worth over N900, 000. [Read more]
Organ Donation
Here's a surprising fact: New York ranks 49th out of the 50 states in percentage of registered organ donors.
That's a situation the New York Organ Donor Network wants to change. "It's a shocking statistic, and we're not very happy about it," says Julia Rivera, the network's director of communications.
That's how Patricia Mayer Van Duser feels, too. Born and raised in Newburgh, Van Duser has been teaching fifth-grade at Fostertown Elementary School for more than 20 years. Since January 2013, she's been on the waiting list for a donor kidney.
A frustrating wait
Van Duser carries a beeper that will alert her as soon as a donor match has been made for her. When that happens, she and two other matches will have to hurry down to Columbia Presbyterian Hospital in New York City to see which one of them will receive a donor kidney.
Van Duser, who will turn 50 in May, is one of 10,000 New Yorkers waiting for an organ transplant today, according to the Donor Network. Nationwide, some 130,000 people are on waiting lists. A single donor has the potential to save up to eight lives, Rivera points out. And that's why it's so frustrating to her that more New Yorkers haven't signed up to save a life.
"The big deal here is that people don't understand that when you sign up on the registry, it simply provides your family an opportunity to know your wishes. It documents your decision so nobody can change that," Rivera says.
There are two easy ways to become a registered organ donor in New York. The state has recently simplified its donor registry that accompanies driver license applications and renewals. And, Donor Network has its own site: donatelifeny.org/hate-the-wait/
[Read more]
Neelie Kroes EU, Vice-President of the European Commission, responsible for the Digital Agenda, said: "mHealth is just one of the benefits of a Connected Continent – helping patients, doctors and carers take control, wherever they are. From simple apps which help you stick to your exercise regime – to monitoring tools for those on kidney dialysis. I am delighted that the EU is so committed to this fascinating area. The EU has already invested over €100 million, with about €95 million up for grabs over the next two years. And we are now consulting on how best to unlock the huge potential of mobile healthcare."
Four EU-funded projects making the most of mHealth 1. Patients with kidney failure to get a new lease of life with Nephron PlusChronic kidney disease will affect one in ten of us at some point in our lives. For those of us unfortunate enough to suffer renal failure, the health consequences can be disastrous and the treatments very complex. The @nephronplus project received €5 million of EU funding to improve the lives of patients by developing a wearable artificial kidney device, whose indications can be remotely monitored by patients on their smartphone, and by medical staff.
A more full and active life. "Continuous, 24/7 dialysis with a wearable device offers a smooth and uniform extraction of toxins over the day similar to the natural kidney. This improves the health condition tremendously and eliminates the 'after dialysis sickness syndrome' that many patients suffer from", explains Frank Simonis, technical manager of NEPHRON+. Constant remote monitoring of data is also a key feature of the system. Via a personal renal care app on their mobile device, patients will be able to consult and manage data, and include alarm settings. Their doctors will also be able to monitor the treatment, and remotely adapt it. According to Simonis "The NEPHRON+ system will make it possible for dialysis patients to lead a more full and active life." [Read more]
From Nephrology News
ASN president urges Congress to create federal prize competition to boost innovative kidney research
On April 9, the president of the American Society of Nephrology (ASN) urged Congress to boost scientific innovation in kidney research through a federal prize competition. In her testimony before the House Science, Space, and Technology Subcommittee on Research and Technology, ASN President Sharon M. Moe, MD, FASN, voiced support for federal prize competitions as a mechanism to incentivize new approaches to renal replacement therapy that could reduce escalating Medicare costs and improve care for the 450,000 Americans with kidney failure.
“I feel strongly that current scientific knowledge in the understanding of the kidney is at a level that makes such life-altering innovation a real possibility. I firmly believe American ingenuity is ready and willing to take this basic knowledge and turn it into a transformative, cost-saving technology that offers real hope for a better life to patients suffering through the current consequences of dialysis. Together, we can offer hope to the 20 million Americans with kidney disease who fear dialysis is in their future,” said Moe, who is a professor of medicine and director of the Division of Nephrology in the Department of Medicine at the Indiana University School of Medicine.
Her testimony at the Prizes to Spur Innovation and Technology Breakthroughs hearing highlights how a federal prize competition for kidney disease would mobilize the development of new tools to address one of the costliest health care challenges the U.S. government faces today.
Nearly 450,000 Americans with kidney failure rely on the Medicare End-Stage Renal Disease (ESRD) Program for lifesaving dialysis. The ESRD Program is the only federal health entitlement program that provides coverage regardless of age or disability. Caring for people with kidney failure costs Medicare nearly $35 billion annually. Patients with ESRD account for less than 1% of the Medicare population but their care constitutes 7% of the program’s budget. [Read more]
From Nephrology News
Kidney disease patients with poor quality of life are at increased risk of experiencing progression of their disease and of developing heart problems, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). The findings suggest that quality of life measurements may have important prognostic value in these individuals.
Quality of life has been well-studied in patients with end-stage renal disease, but not in patients with CKD who do not yet require dialysis, according to background information in the study. To gain a better understanding of quality of life among such patients, Anna Porter, MD, from the University of Illinois at Chicago, and her colleagues studied 1,091 African Americans with hypertensive CKD enrolled in the African American Study of Kidney Disease and Hypertension Trial and Cohort Studies. The researchers assessed health-related quality of life, including mental and physical health, through surveys.
During approximately 10 years of follow-up, lower physical and mental health scores were linked with increased risks of experiencing cardiovascular events or dying from heart-related causes as well as with experiencing progression of CKD or dying from kidney-related causes.
“Quality of life is extremely important to patients and is impacted by kidney disease,” said Porter. “In order to better serve our patients, physicians need to gain a better understanding of the negative impact that kidney disease has on quality of life, and to recognize the association between quality of life and other outcomes.”
Quality of life has been well-studied in patients with end-stage renal disease, but not in patients with CKD who do not yet require dialysis, according to background information in the study. To gain a better understanding of quality of life among such patients, Anna Porter, MD, from the University of Illinois at Chicago, and her colleagues studied 1,091 African Americans with hypertensive CKD enrolled in the African American Study of Kidney Disease and Hypertension Trial and Cohort Studies. The researchers assessed health-related quality of life, including mental and physical health, through surveys.
During approximately 10 years of follow-up, lower physical and mental health scores were linked with increased risks of experiencing cardiovascular events or dying from heart-related causes as well as with experiencing progression of CKD or dying from kidney-related causes.
“Quality of life is extremely important to patients and is impacted by kidney disease,” said Porter. “In order to better serve our patients, physicians need to gain a better understanding of the negative impact that kidney disease has on quality of life, and to recognize the association between quality of life and other outcomes.”
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