Archive for January, 2013

Single-Use versus Reusable Dialyzers: The Known Unknowns

Thursday, January 31, 2013 | By Scott | 3 Comments

Ashish Upadhyay, Marie Anne Sosa, Bertrand L. Jaber

The practice of reusing dialyzers has been widespread in the United States for decades, with single use showing signs of resurgence in recent years. Reprocessing of dialyzers has traditionally been acknowledged to improve blood–membrane biocompatibility and prevent first-use syndromes. These proposed advantages of reuse have been offset by the introduction of more biocompatible membranes and favorable sterilization techniques. Moreover, reuse is associated with increased health hazard from germicide exposure and disposal. Some observational studies have also pointed to an increased mortality risk with dialyzer reuse, and the potential for legal liability is another concern. The desire to save cost is the major driving force behind the continued practice of dialyzer reuse in the United States. It is imperative that future research focus on the environmental consequences of dialysis, including the need for more optimal management of disinfectant-related waste with reuse, and solid waste with single use. The dialysis community has a responsibility to explore ways to mitigate environmental consequences before single-use and a more frequent dialysis regimen becomes a standard practice in the United States.

Dialyzer reuse has been practiced in the United States for decades but remains a topic of ongoing controversy.

Read more in the Clinical Journal of the Society of Nephrology

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Controversial Kidney-Dialysis Law Upheld by Florida Court

Sunday, January 27, 2013 | By arlene | 1 Comment

It appears that Florida realizes the “Conflict of Interest” of dialysis centers sending patients to their very own labs, is not in the best interest of patients. I applaud them and more States and CMS (Medicare) should stand up to the self interest. The Anti-kickback and Stark Law were passed for every other Physician except Nephrologists.

Read the Courts decision!

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Davita Executives Spend The Day Giving Life in Dialysis Centers

Sunday, January 27, 2013 | By arlene | No Comments

Davita Executives take one day to learn more about what is involved with care issues in their dialysis clinics.

It is nice to learn they are finally learning that the patient counts not dollars. 

Read more

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Bill Would Repeal The Amgen Gift From Washington

Saturday, January 26, 2013 | By arlene | No Comments

By Ed Silverman // January 24th, 2013 // 9:14 am

Following disclosure that the recently passed ‘fiscal cliff’ bill delays Medicare price restraints on a group of medications that will benefit Amgen while costing taxpayers up to $500 million over two years, a Vermont congressman yesterday introduced legislation to repeal the controversial largesse.

The ‘fiscal cliff’ bill gives the biotech an extra two years to sell Sensipar, a pill that is used for kidney dialysis and generatd $808 million in sales in 2011. But Amgen also contributed generously to several US Senators who had direct influence over the final language (back story and section 632 in the bill is here).The revelation prompted outrage over the old-fashioned political horsetrading, especially since this comes at a time when the nation is debating not only rising healthcare costs, but also the national debt.

“This eleventh-hour, backroom deal confirms the American public’s worst suspicions of how Congress operates,” says Democrat Peter Welch in a statement.“As the nation’s economy teetered on the edge of a Congressional-created fiscal cliff, lobbyists for a private, for-profit company seized an opportunity to feed at the public trough. Without scrutiny or debate, the American taxpayer was stuck with the $500 million tab. This special interest provision should have stood on its own merits with an up or down vote. It’s no wonder cockroaches and root canals are more popular than Congress.”

There are three co-sponsors – New York Republican Richard Hanna, Tennessee Democrat Jim Cooper and Bruce Braley, a Democrat from Iowa. The bill has been referred to the House Committee on Energy and Commerce and the House Committee on Ways and Means. As soon as the bill becomes available, we will provide a link.

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PATIENT CONCERNS ADDRESSED IN MICHIGAN DAVITA CLINIC

Friday, January 25, 2013 | By arlene | No Comments

1-17-2013

Hi Arlene!

I wanted to thank you again for helping us with Phillip’s dialysis care at Davita, in Clarkston Michigan. I wanted to share with your readers our story, as well. Phillip, my husband has been on dialysis for 5 years and is very vigilant on trying to maintain his health while suffering end stage renal failure. Phillip’s story began in late 1999 when he was in full renal failure after being put on medicine for gout. This medicine created protein kidney stones that blocked his urethra and cut off the blood flow to his kidneys. Going on dialysis was definitely scary for us but after he had been placed on dialysis he had improved and started to feel better. He soon suffered a heart attack and had to have emergency Triple bypass surgery…

Continue Reading: PATIENT CONCERNS ADDRESSED IN MICHIGAN DAVITA CLINIC

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JUST SAY NO TO REUSE

Thursday, January 24, 2013 | By arlene | No Comments

DO YOU KNOW YOU HAVE THE RIGHT TO HAVE A NEW DIALYSER EACH TIME YOU ARE DIALYSED? 

What is reuse? Reuse is the term for using a dialyser more than once on a patient. Originally dialyser were labeled SINGLE USE ONLY, after lobbying by the industry they were relabeled for multiple use under direction of the patient’s doctor. 

Why should I ask for a new dialyser? In order to reuse a dialyser it needs to be treated with chemicals then rinsed thoroughly. The chemicals used are deadly and if not completely removed before use on a patient they can lead to serious medical problems or death. You are trusting that the person handling your dialyser is fully trained in this process, not over loaded with patients, and mistake free.

Would you do this with your car? We take our vehicles in for an oil change, would you let them take off the oil-filter rinse it out and reuse it? 

FRESENIUS SAYS NO TO REUSE: Fresenius dialysis care centers stopped using reuse dialyzers after questions were brought up about potential harm to patient. 

Posted in a Davita reception room: If you require hemodialysis and dialyser reuse is practiced in the facility, you are entitled to the following:

* To give or refuse permission to participate in the reuse program and to request to change from one to the other at any time either verbally or in writing. Refusal to participate in reuse will still allow the patient to dialysis in this facility and receive other services, however, failure to agree to reuse will minimally restrict the choice of dialyser.”  

 Problems that have occurred from reuse
      Mix-up, another patients dialyser used (other patient may have a contagious diseases) 
      Reuse dialyser not completely rinsed and chemical free (resulting in serious problems or death)
 
Patients who have stopped reuse have shared how much better they feel after they requested single use dialyser. Some have said they felt better almost immediately.
 
Its your choice, you have the power to say no to reuse.   
 
Read more about reuse vs single use dialyser From: Journal of the American Society of Nephrology

 

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