I am an RN working in Dialysis for seven years now. Currently I work full time in Peritoneal Dialysis(Home Therapies) and per diem in Hemodialysis- Chronic and Acutes. I offer Dialysis Options. Most of my time in Dialysis has been in Chronic(out Patient) Hemodialysis. I have been a Nurse for about 20 years and although my time in Dialysis has only been one 3rd of my Nursing career I have totally immersed myself into this science & can definitely see myself connected to Dialysis for the rest of my Nursing career and beyond.

Search Joe Dialyzer

Friday, April 30, 2010

'JumpStart' uses retired Rochester officer's story to highlight kidney disease

(CARLOS ORTIZ staff photographer)
Jon Hand • Staff writer • April 29, 2010  JHAND@DemocratandChronicle.com

The current story line of the comic strip JumpStart has been pulled from the real-life health problems of retired Rochester police Officer Greg Raggi, a dialysis patient who has been in line for a life-saving kidney transplant for 3 ½ years.
Artist Robb Armstrong's strip, which is printed daily in the Democrat and Chronicle, features the lives of a fictional police officer, Joe, and his wife, Marcy, a nurse.
Since April 12, the strip has focused on Joe's "cop lifestyle" of eating fast fatty foods, working long hours and dealing with high stress. In the past few days, Joe and Marcy have discussed how that lifestyle can lead to diabetes and renal failure. In a subplot of the comic, Joe's partner, Crunchy, has left the fictional world of JumpStart to give his brother, Stanley (also a police officer), a kidney because Stanley has diabetes.
Armstrong said he developed the story line after a phone call from Mike Mazzeo, a friend and longtime partner of Raggi's in the narcotics unit of the Rochester Police Department.
Mazzeo, who is also the president of the Locust Club, the city police officer's union, first met Armstrong last year during a dust-up over a strip by Armstrong depicting a police shooting. The strip ran about the same time two city officers were shot and some in the community criticized Armstrong and the newspaper for being insensitive.
Mazzeo disagreed and publicly came to Armstrong's defense.
A bond was formed and the next time Mazzeo talked to Armstrong, he was asking him to help his friend, Raggi, and bring awareness to a problem many officers are concerned about.
"It's something that has affected many of us," said Mazzeo, who spent many hours taking his own father to dialysis treatments.
At least one other retired Rochester officer, Stan Prewasnick, is on dialysis and a third, Lt. Lou Genovese, died this past year after spending a year on dialysis, Mazzeo said.
Armstrong said he loved the idea right away.
"I have people walking up to me all the time saying, 'This is so funny, you have to write about it in JumpStart,'" Armstrong said from his home in Pasadena, Calif. "Mike came up to me and told me about something that wasn't funny but was so important. I said: 'Wow, this isn't just good for JumpStart, this is perfect.'"
Dr. Carlos Marroquin, a transplant surgeon from Strong Memorial Hospital, said no studies have been done to calculate whether police officers have a higher incidence of renal failure compared to other professions. But it's clear, Marroquin said, poor diet and stress can be a harmful combination.
"Clearly it is an issue, given the lifestyle, the stress, the dietary habits of a police officer," said Marroquin, who, at Mazzeo's invitation, spoke to union members in March to discuss kidney health and the safety of becoming "live donors." Donna Dixon, education director for the local chapter of the National Kidney Foundation, also spoke to the officers.
For his part, Raggi acknowledges that many of his old habits as an officer likely "caught up with him."
"I'm sure, eating the way I did, sleeping the way I did, middle shifts, night shifts, waking up early for court, it all took a toll on me," he said. "I'm not complaining. I loved it. But I wish I'd known better."
He retired in 1993 after 20 years in the department, and was diagnosed with Type 2 diabetes in 1995. The symptoms became more prevalent following a heart attack in 2004 and he went on the donor list in 2006.
He began peritoneal dialysis about 18 months ago, which requires Raggi to attach a tube leading from a suitcase-sized machine to a permanent tube in his abdomen each night for about nine hours while he sleeps. The process takes the place of the natural function of Raggi's kidneys, to filter toxins from his blood.
"I feel OK. I have good days and bad days; my doctor tells me to hang in there," said Raggi.
Doctors told him to expect it to take four to five years to find a donor kidney from the date he was placed on the list.
That surgery would change his life, he said. He's been looking forward to one thing, in particular.
"We never travel anymore because of the dialysis," he said. "I'd like to take a trip with my wife."
JHAND@DemocratandChronicle.com

Sunday, April 25, 2010

Nasal mupirocin prevents Staphylococcus aureus

If you are a Peritoneal Dialysis patient or a PD Nurse you may want to mention this study in your clinic and ask for the opinion of the professionals in the office. 
J Am Soc Nephrol. 1996 Nov;7(11):2403-8.

Nasal mupirocin prevents Staphylococcus aureus exit-site infection during peritoneal dialysis. Mupirocin Study Group.

[No authors listed]

Abstract

A total of 1144 patients receiving continuous ambulatory peritoneal dialysis in nine European centers was screened for nasal carriage of Staphylococcus aureus. Two hundred sixty-seven subjects were defined as carriers of S. aureus by having had at least two positive swab results from samples taken on separate occasions, and were randomly allocated to treatment or control groups. Members of each group used a nasal ointment twice daily for 5 consecutive days every 4 wk. The treatment group used calcium mupirocin 2% (Bactroban nasal; SmithKline Beecham, Welwyn Garden City, United Kingdom) and the control group used placebo ointment. Patients were followed-up for a maximum period of 18 months. There were 134 individuals in the mupirocin group, and 133 individuals acted as control subjects. There were no differences in demographic data, cause of renal failure, type of catheter, system used, or method of exit-site care between the groups. Similarly, there were no differences in patient outcome or incidence of adverse events between both groups. Nasal carriage fell to 10% in those subjects who received active treatment and 48% in those who used the placebo ointment. There were 55 exit-site infections in 1236 patient-months in the control group and 33 in 1390 patient-months in the treatment group (not significant). S. aureus caused 14 episodes of exit-site infection in the mupirocin group and 44 in the control group (P = 0.006, mixed effects Poisson regression model). There were no differences in the rate of tunnel infection or peritonitis. There was no evidence of a progressive increase in resistance to mupirocin with time. Regular use of nasal mupirocin in continuous ambulatory peritoneal dialysis patients who are nasal carriers of S. aureus significantly reduces the rate of exit-site infections that occurs because of this organism.
PMID: 8959632 [PubMed - indexed for MEDLINE]

Thursday, April 22, 2010

See Social Networking can be Very Good!

Conn. mayor donates kidney to Facebook friend

Carlos Sanchez AP – Kidney recipient Carlos Sanchez poses for a photograph at his home in East Haven, Conn., Wednesday, April …
HARTFORD, Conn. – Politicians long ago discovered the uses of Facebook. East Haven Mayor April Capone Almon found something else there: a constituent who needed her kidney. Capone Almon, 35, had more than 1,600 "friends" on Facebook last year when she saw one of them, Carlos Sanchez, post a status update saying his friends and relatives had all been tested and couldn't donate a kidney. She knew him casually through activities and friends in the New Haven suburb of East Haven, but they weren't so close that she had heard he was ill. Sanchez, a 44-year-old father whose kidneys were failing because of diabetes, sent out the request on Facebook only hesitantly and on his doctor's suggestion. He worried people might pity him — and certainly hadn't pinned his hopes on finding a donor that way. He didn't have long to wait. Capone Almon was the first person to respond. "I sent him a private message and just said, 'Hey, I'll try. I'll get tested,'" Capone Almon said Wednesday. "I really felt from the very beginning that I was going to be a match and a donor. I don't know why, but I just knew it." Sanchez had no such certainty. "I thought she was joking. The mayor of East Haven would offer me her kidney?" said Sanchez, an office administrator. "She responded back and said, 'I am serious, I am willing to get tested.' "I wasn't putting too much faith in it," he said. "I didn't want to get my hopes high. But at a point she made me feel so comfortable that I started feeling maybe this was meant to be." Capone Almon, a Democrat, was running for second term as mayor at the time but kept the details of her medical plans a secret. She won the election as they awaited word on when she could donate the kidney, saying they grew as close as family during the lull. "I know he voted for me, too," she joked. The operation was set only after Capone Almon passed a battery of tests and was given a long explanation of the process, which involved three small incisions near her ribcage and a scar similar to that of a cesarean section. "What the doctors said to me is, 'Your recipient is already sick and we're not going to make you sick to make him somewhat better,'" she said. "They do not compromise the donor's health in any way, shape or form." Their tenuous connection was cemented into a lasting bond April 8, when doctors at Yale-New Haven Hospital removed Capone Almon's left kidney and transplanted it into Sanchez. They were released from the hospital in less than a week and are expected to make full recoveries. His insurance paid for both their surgeries, and the mayor is back on the job in this middle-class city of about 30,000. Capone Almon said that she fields questions almost daily from people asking whether she's worried her one remaining kidney might someday fail, but that she's confident enough in modern medicine and her own health — especially after the numerous tests — that she barely gives it a thought. "I don't want people to see this as something larger than life," she said. "There's nothing special about me. Anybody can try to do this, and if it's meant to be, you'll be a match and a donor and you can really help someone." Michael Lawlor, an East Haven attorney and longtime friend of Capone Almon's, said she kept the details of her plans private for a long time, even as he and others quizzed her to ensure she recognized the serious nature of the donation. "I remember saying, 'Wow, that's really something. I wonder if she's really thought through the fact that it might actually be a match,'" said Lawlor, the area's state representative to the General Assembly. "Almost everybody says the same thing: I don't know if I would do that if it wasn't a relative ... but she said, 'No problem,'" he said. "When she found out she was a match, she was genuinely happy and truly excited to do it."

Transplant!!!!!


Many of you may remember Keith Barr from our 2010 Geneseo Kidney Walk - his outgoing personality and creative advertising caught all of our attentions!!
We are very excited to announce that Mr. Barr received notice last Wednesday that a kidney was available to him - and he received his transplant on Thursday. I spoke with Keith today and he said he is feeling great! We want to send a congratulations to him and his family - we are all so excited for you and wish you the best!
Keith promised to attend the Geneseo Kidney Walk next year with a sign that says "Received My Kidney 1 year ago!"
We are all very excited to see Keith and the rest of our great kidney walkers next year!
Michelle Castrogiovanni
Division Special Events Manager
National Kidney Foundation
Serving Upstate New York

Sunday, April 18, 2010

NKF Healthy Tips!!! Toss the Salt!

TOSS THE SALT!
——————————————
LIVE LONGER.
New research shows dramatic
health benefits from reducing salt
intake by just 1/2 teaspoon per
day, resulting in a longer and
healthier life!
What is 1/2 teaspoon of salt?
1150mg of salt or 460mg of sodium
Helpful Hints to being Salt Smart:
♦ Toss your salt shakers!
♦ Cook with herbs and spices
instead of salt
♦ When eating out, ask for foods
without salt
♦ Cook and eat fresh foods
♦ Avoid processed foods
BE SALT SMART
AND
SODIUM SENSIBLE!

Friday, April 16, 2010

If PD fails: Think about home HD

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If PD fails: Think about home HD

Some people happily do peritoneal dialysis (PD) for 10, or 15, or even 20, years. But many who choose PD stop after just 2–3 years.1 The peritoneum may fail, or they may have "buyer's remorse" if PD doesn't fit their lives the way they hoped it would.
If this happens to you and you don't have a kidney transplant donor lined up, you'll need to switch to a form of hemodialysis (HD). Why not home HD?    

Quality of life on PD vs. HD

When making a switch from PD to HD, it makes sense to think about how your quality of life will be affected.
Standard in-center HD three times a week for 3–4 hours can be a "default" treatment. People may end up with it and not even know that there are other options.2 But PD is always done as a conscious choice. A study of why people choose PD in the first place found these reasons:3
  • Flexible schedule
  • Convenience of being home
  • Option of nighttime treatments
Statements from people who do PD bear out these key points:
"[In-center] hemodialysis wore me out, to where I couldn't do much other than go to treatments and sleep. Then I found PD, which no one had ever talked with me about before—and after a little research, I made the switch. It was the BEST choice I ever made. I now use a cycler at night, and work during the day."
"I had a terrible time on [in-center] hemo. I was scared at first because I wasn't sure if I could be in charge of my own care. But the difference is night and day for me. I have taken charge, and not only do I feel better physically but emotionally and spiritually too."
"Personally, I prefer PD to even the thought of HD. PD does not interfere with my lifestyle as much as HD would. I am very busy and tell people that I do not have time to sit on a machine for 4–5 hours 3 days a week. I do PD at night on a cycler and am dry during the day so can forget about dialysis during the day. I am able to continue all my activities and work. If I were on [in-center] HD I would have to quit work and would be unable to be as active as I am."
One study looked at quality of life in 60 people on PD and 60 on HD.4 It found that those on PD had a much better quality of life in the areas of:
  • Stress
  • Sleep
  • Social function
  • Major depression
And, on a scale of 1-10 (with 10 being high), people on PD rated their overall satisfaction at 8.02. Those on standard in-center HD rated theirs at 7.25—significantly lower.5 Why choose a treatment with which people are less satisfied?

Survival on PD vs. in-center HD 

A new study matched 6,337 pairs of people who started PD or standard in-center HD in 2003. It found much better survival on PD than on HD.6 This was even more true for those under age 65, those who did not have heart disease, and those who did not have diabetes.
While those on PD don't seem to fare any worse after switching to in-center HD,7 why not aim for better?

Types of home HD

Medicare rules as of 2008 require people with kidney failure to be told about all of their treatment options—and where to get them.8 But we suspect that this is not yet happening everywhere. If PD is no longer working for you, and you need to make a switch, knowing your home options can help you choose a treatment that will fit your life:   

   small home hemo machine

  1. Conventional home HD (CHD) – This treatment is done 3x/week. A huge plus of PD is getting treatment all or nearly all the time, so you don't have "ups and downs." CHD 3x/week will give you ups and downs. Just 3 treatments also means more fluid and diet limits and meds to take. And, just 3 treatments raises your risk of sudden cardiac death on the day after the 2-day no-treatment weekend by 50%.9 You can schedule treatments when you want, though, and be at home.
  2. Short daily home HD (SDHD) – A small machine (about the size of a microwave รข€“ see below) is used to do 2–3 hour treatments 5–6 days a week. You won't have ups and downs,10,11 can have a more normal diet and fluids, and won't need as many blood pressure pills12 or binders. While it can take as long as 6.67 hours to feel well again after standard HD, those on SDHD felt well in 30 minutes or less.13 Studies find that survival on SDHD is much better than standard HD or PD—in fact, it's about the same as deceased donor transplant!14,15   
  3. Nocturnal home HD (NHHD) – HD treatments are done for 6–8 hours at night while you sleep, 3–6 times/week. Slow, gentle treatments are easy on the heart—and clean the blood so well that no special diet or fluid limits may be needed,16,17 and blood pressure pills can be stopped.18 People feel well about 10 minutes after NHHD treatments.13

    Most who do PD use a cycler at night. NHHD is the closest to this, in terms of lifestyle. People who switched from PD to NHHD had higher levels of protein in their blood, higher hemoglobin levels (with less EPO). They had lower levels of phosphorus—even though they didn't need binders.19 NHHD was not any more of a burden than PD. Finally, like SDHD, studies have found that survival on NHHD is about the same as deceased donor transplant.21,22

Barriers to home HD

Dialysis needles. The most obvious barrier in switching from PD to home HD are the dialysis needles. Some programs permit home HD using a catheter. HD catheters at home are safer than in-center.23 Learning how to put in your own needles if you have a fistula or graft puts control in YOUR hands and removes a lot of the pain and fear. You can read about how to do this in our articles:
If you are going to have to have needles anyway for HD, you might as well get the benefits of longer and/or more frequent home treatment!
Needing a partner. Many programs require a partner for home HD. If you don't have one, look for programs that do not require this. Or, see if you can do in-center nocturnal treatments (3x/week) in your town. This gives you most of the pluses of home treatment with no need for a partner.
Finding a home HD program. Not knowing where to find home HD can also stop you. Look at the "Find a Clinic Near You" database on Home Dialysis Central to search by type of treatment and zip code.
Both PD and home HD have been growing. We have kept track of the numbers of home programs since we started Home Dialysis Central in 2004, and this is what we've seen: 
Treatment '04 '09 % Growth
CAPD 1460 2143 46.7
CCPD 1428 2126 48.9
3x week HHD 294 765 160.2
Daily HHD 37 537 1351.3
Nocturnal HHD 73 274 275.3
There are about 5,000 U.S. dialysis clinics. In 2004, about 30% had some type of PD. Today, about 45% do. Growth has been much higher in home HD, but only about 15% of clinics offer some type of home HD.

Conclusion

You may or may not want to switch from PD to some form of HD. But if you need to for some reason, it's good to know that there are home HD treatment options that can help you keep the freedom, flexibility, and control of PD.

References

  1. Jaar BG, Plantinga LC, Crews DC, Fink NE, Hebah N, Coresh J, Kliger AS, Powe NR. Timing, causes, predictors, and prognosis of switching from peritoneal dialysis to hemodialysis: a prospective study. BMC Nephrol. 2009 Feb 6;10:3.
  2. USRDS 1997 Annual Data Report, USRDS Dialysis Morbidity and Mortality (Wave 2), 53.
  3. Wuerth DB, Finkelstein SH, Schwetz O, Carey H, Kliger AS, Finkelstein FO. Patients' descriptions of specific factors leading to modality selection of chronic peritoneal dialysis or hemodialysis. Perit Dial Int. 2002 Mar-Apr;22(2):184-90.
  4. Noshad H, Sadreddini S, Nezami N, Salekzamani Y, Ardalan MR. Comparison of outcome and quality of life: haemodialysis versus peritoneal dialysis patients. Singapore Med J. 2009 Feb;50(2):185-92.
  5. Juergensen E, Wuerth D, Finkelstein SH, Juergensen PH, Bekui A, Finkelstein FO. Hemodialysis and peritoneal dialysis: patients' assessments of their satisfaction with therapy and the impact of the therapy on their lives. Clin J Am Soc Nephrol. 2006 Nov;1(6):1191-6.
  6. Weinhandl ED, Foley RN, Gilbertson DT, Arneson TJ, Snyder JJ, Collins AJ. Propensity-matched mortality comparison of incident hemodialysis and peritoneal dialysis patients. J Am Soc Nephrol. 2010 Mar;21(3):499-506. Epub 2010 Feb 4.
  7. Van Biesen W, Dequidt C, Vijt D, Vanholder R, Lamiere N. Analysis of the reasons for transfers between hemodialysis and peritoneal dialysis and their effect on survivals. Adv Perit Dial. 1998;14:90-4.
  8. Medicare and Medicaid Programs; Conditions for Coverage for End-Stage Renal Disease Facilities; Final Rule, from CMS. Accessed 3/2010.
  9. Bleyer AJ, Russell GB, Satko SG. Sudden and cardiac death rates in hemodialysis patients. Kidney Int. 1999 Apr;55(4):1553-9.
  10. Okada K, Abe M, Hagi C, Maruyama N, Ito K, Higuchi T, Matsumoto K, Takahashi S. Prolonged protective effect of short daily hemodialsyis against dialysis-induced hypotension. Kidney Blood Press Res. 2005;28(2):68-76.
  11. Goldfarb-Rumyantzev AS, Leypoldt JK, Nelson N, Kutner NG, Cheung AK. Crossover study of short daily haemodialysis. Nephrol Dial Transplant. 2006 Jan;21(1):166-75.
  12. Fagugli RM, Reboldi G, Quintaliani G, Pasini P, Ciao G, Cicconi B, Pasticci F, Kaufman JM, Buoncristiani U. Short daily hemodialysis: blood pressure control and left ventricular mass reduction in hypertensive hemodialysis patients. Am J Kidney Dis. 2001 Aug;38(2):371-6.
  13. Heidenheim AP, Leitch R, Kortas C, Lindsay RM. Patient monitoring in the London Daily/Nocturnal Hemodialysis Study. Am J Kidney Dis. 2003 Jul;42(1 suppl):61-5.
  14. Blagg CR, Kjellstrand CM, Ting GO, Young BA. Comparison of survival between short-daily hemodialysis and conventional hemodialysis using the standardized mortality ratio. Hemodial Int. 2006 Oct;10(4):371-4.
  15. Kjellstrand CM, Buoncristiani U, Ting G, Traeger J, Piccoli GB, Sibai-Galland R, Young BA, Blagg CR. Short daily haemodialysis: survival in 415 patients treated for 1006 patient-years. Nephrol Dial Transplant. 2008 Oct;23(10):3283-9.
  16. Geary DF, Piva E, Tyrrell J, Gajaria MJ, Piccone G, Keating LE, Harvey EA. Home nocturnal hemodialysis in children. J Pediatr. 2005 Sep;147(3):383-7.
  17. Warady BA, Fischbach M, Geary D, Goldstein SL. Frequent hemodialysis in children. Adv Chronic Kidney Dis. 2007 Jul;14(3):297-303.
  18. Nesrallah G, Suri R, Moist L, Kortas C, Lindsay RM. Volume control and blood pressure management in patients undergoing quotidian hemodialysis. Am J Kidney Dis. 2003 Jul;42(1 Suppl):13-7.
  19. Wong JH, Pierratos A, Oreopoulos DG, Mohammad R, Benjamin-Wong F, Chan CT. The use of nocturnal home hemodialysis as salvage therapy for patients experiencing peritoneal dialysis failure. Perit Dial Int. 2007 Nov-Dec;27(6):669-74.
  20. Fong E, Bargman JM, Chan CT. Cross-sectional comparison of quality of life and illness intrusiveness in patients who are treated with nocturnal home hemodialysis versus peritoneal dialysis. Clin J Am Soc Nephrol. 2007 Nov;2(6):1995-200.
  21. Pauly RP, Gill JS, Rose CL, Asad RA, Chery A, Pierratos A, Chan CT. Survival among nocturnal home haemodialysis patients compared to kidney transplant recipients. Nephrol Dial Transplant. 2009 Sep;24(9):2915-9.
  22. Johansen KL, Zhang R, Huang Y, Chen SC, Blagg CR, Goldfarb-Rumyantzev AS, Hoy CD, Lockridge RS Jr, Miller BW, Eggers PW, Kutner NG. Survival and hospitalization among patients using nocturnal and short daily compared to conventional hemodialysis: a USRDS study. Kidney Int. 2009 Nov;76(9):984-90.
  23. Perl J, Lok CE, Chan CT. Central venous catheter outcomes in nocturnal hemodialysis. Kidney Int. 2006 Oct;70(7):1348-54.
  24. Dialysis Needle Fear: Easing the Sting, Home Dialysis Central. Accessed 3/2010.
  25. Dialysis Needles, Self-Cannulation, and the Buttonhole Technique, Home Dialysis Central. Accessed 3/2010.
  26. Copland M, Murphy-Burke D, Levin A, Singh RS, Taylor P, Er L. Implementing a home haemodialysis programme without adversely affecting a peritoneal dialysis programme. Nephrol Dial Transplant. 2009 Aug;24(8):2546-50.
Copyright © 2010 Medical Education Institute, Inc. All rights reserved.

Wednesday, April 14, 2010

Innovative HeRO® Device

Innovative HeRO® Device Improves
Outcomes, Quality of Life for Kidney Disease Patients 
1,000 patients nationwide have now received the device
from Minnesota-based Hemosphere, Inc.
February 24, 2010 – Eden Prairie, Minn. – One thousand end stage renal disease patients have now benefited from a novel device that provides vital access to their blood for filtering and replacement kidney function and reduces the risk of potentially fatal bacteremia infection.
The HeRO® Vascular Access Device, produced by Hemosphere, Inc., in Eden Prairie, Minn., provides access for hemodialysis similar to a conventional graft. The device is surgically implanted completely under the skin and its innovative design bypasses central venous damage caused by catheters. More than 1,000 patients in over 220 hospitals across the United States have received the device since its commercialization in May 2008.
“Reaching this significant medical milestone demonstrates increasing physician acceptance of the HeRO Vascular Access Device and its positive contribution toward improved quality of life for kidney disease patients,” said Doris Engibous, President and CEO of Hemosphere, Inc. “The strong clinical results, and the subsequent increasing adoption of the device, reinforce that HeRO can provide improved vascular access performance and reduce healthcare costs compared to catheters.”
Before the introduction of HeRO, hemodialysis patients received a tunneled dialysis catheter when the damage to their central venous systems prevented them from supporting a fistula or graft. Catheters have a number of disadvantages, including high rates of life-threatening infection, inadequate dialysis compared to fistulas and grafts, and are widely known to cause damage to the central veins over time.
HeRO has the potential to establish a new standard of vascular access care to reduce long-term catheter use. The device provides a new option that improves a patient’s quality of life by increasing the effectiveness of hemodialysis treatment and reducing a patient’s risk of developing an often-fatal systemic infection.
“The HeRO device allows for better and more efficient dialysis, so many of my patients who have been implanted with HeRO say they feel better and have more energy,” said Dr. Brad Grimsley, vascular access surgeon at Texas Vascular Associates in Dallas, who performed the 1,000th implant. “Because HeRO is implanted under the skin, it has a significantly lower risk of potentially life-threatening infections than a catheter and allows my patients to enjoy daily activities, like showering or swimming, without worrying about exposing their access to germs and bacteria.”
How HeRO Works
The HeRO Vascular Access Device is made up of two pieces that are surgically implanted under the skin. During surgery, a reinforced tube (called the outflow component) is inserted directly into a large vein in the neck. X-ray is used to direct the tube past any blockages that have caused trouble for other access sites. A regular dialysis graft is sewn to an artery, just like a conventional graft. The graft is then joined to the outflow component with a special proprietary connector. Once the system is in place, blood will flow from the artery through the graft and
Internal Use Only: 15-0002, Press Release 1,000th Implant
outflow component into the heart. Unlike a catheter, there is continuous blood flow even when a patient is not receiving dialysis treatment.
“Our customers, including our earliest supporters in the clinical trial, as well as the dialysis care centers and our most recent certified surgical implanters, are the key to our success. Without their belief and support, HeRO would not be the solution for access challenged patients,” said Engibous. “We are committed to collaborating with clinicians and other members of the dialysis care continuum to improve clinical outcomes for patients for years to come.”
About Hemosphere, Inc. Hemosphere, Inc., is leading innovation and collaboration in the global development and commercialization of technologies that revolutionize care and restore quality of life for end-stage renal disease patients with compromised vasculature.
For more information on Hemosphere, Inc and the HeRO® Vascular Access Device, visit the company’s Web site at www.heroaccess.com.

Monday, April 12, 2010

Great Re-Blog, Post By Bill Peckham-DSEN.

The Good Dialysis Index

Good_dialysisBy Bill Peckham
Dr. Agar has posted his Good Dialysis Index, which he presented during the morning session of Comprehensive Course in Hemodialysis on the Saturday of the Annual Dialysis Conference weekend last month in Seattle.
Answering yes to one of the 20 questions earns you a point; anything above 16 indicates Good Dialysis. This simplicity is a design feature. The idea is to create something usable, that matches clinical experience.
The Good Dialysis Index is a survey across four categories of questions: Patient Directed; Process Directed; Laboratory Directed; Chart Directed. Agar acknowledges that any snap shot of dialysis quality will give an incomplete picture, but over time a good GDI score will mean more than a good Kt/V.

Sunday, April 11, 2010

Patient Champion Series: I wanted to share some of these awesome human stories that FMC has shared with me.

Age 41 • Kansas City, Mo. • Featured on March 24, 2010 
Helping Other Patients With Ambitious Work Ethic
Marian Carr, a 41-year-old dialysis patient, was diagnosed with end stage renal disease (ESRD) in July 2002. She went on dialysis and shortly after regained her kidney function for nearly five years. Marian then returned back to dialysis in 2007, had an unsuccessful kidney transplant in 2009, and now receives in-center hemodialysis at Fresenius Medical Care Kansas City Dialysis. The cause of her kidney failure is unknown, although her father had kidney trouble too.
Despite her struggles with ESRD, Marian has persevered and continues to set and accomplish ambitious goals. She firmly believes that people should live the life they want to have, and not let health restrictions or setbacks get in the way.
Among many academic accomplishments, Marian completed her doctorate in psychology and obtained an International Counseling Certification from the Viktor Frankl Institute of Logotherapy – all while managing her dialysis schedule. As part of her doctoral thesis, she developed a counseling model for dialysis patients. Marian is currently active in two nonprofit organizations, as president of the local Minority Donor Awareness Group, and board chair of the Renaissance Education Group in Durham, N.C., which provides education programs for disadvantaged high school students.
To accommodate Marian’s rigorous schedule and numerous travels for work and vacation, she utilizes the Fresenius Medical Care Patient Travel Service. She has traveled all across the U.S., including trips to Dallas, New Orleans, Boston, Florida, Indiana, Michigan, California and North Carolina.
When she's not working, Marian enjoys reading and spending lots of time with her family. She is the eldest of four children and has two nieces and two nephews. This year, Marian and her friend have started a small business to provide counseling and training services for adults, and they plan on expanding it.

Friday, April 9, 2010

Patient Champion Series: I wanted to share some of these awesome human stories that FMC has shared with me.

Age 33 • Tampa, Fla. • Featured on March 23, 2010
Nighttime Dialysis Allows Patient to Dream Big

Tanysha Pitts, a 33-year-old Tampa, Fla., resident, is living her dream, and likes to spread the word that anything is possible on dialysis. Tanysha, who has had kidney failure for almost 20 years as a result of a case of prolonged strep throat, is an in-center nighttime dialysis patient at Fresenius Medical Care Tampa North. Her unique treatment schedule (dialyzing overnight), which she began in 2008, has enabled her to pursue her education as a full-time medical student at Sanford Brown Institute.
Tanysha's dedication to her studies as medical assistant and to her dialysis treatment inspires patients and staff alike at her facility. Her passion for the medical field and her goal to one day work with people with chronic illnesses stems from her personal experience with kidney disease. Tanysha says she sees many young people starting dialysis who feel their lives have changed forever, but she is there to tell them a different story. Tanysha talks to her fellow patients about their dialysis treatment options and encourages them to try the nighttime program, sharing her success on the treatment plan and how they can fulfill their own dreams.
Tanysha will graduate from Sanford Brown Institute with her medical assistant certification in late March 2010, and plans on pursuing another degree in nursing or social work. In addition to school, Tanysha enjoys cooking, spending time with her friends, volunteering at various organizations and attending church services.

Wednesday, April 7, 2010

NKF Healthy Tips!!!





Four Ways to Eat Healthier if You Have Kidney Disease

The nation’s sports fans are focused on the Final Four in April, but for those with chronic kidney disease, National Food Month is an opportunity to learn about the first four dietary nutrients to monitor with these tips from the National Kidney Foundation.

1. Protein

Getting the right amount of protein is important to your overall health and how well you feel. Your body needs the right amount of protein to:
  • Build muscles
  • Repair tissue
  • Fight infections
Your doctor may recommend that you follow a diet that has controlled amounts of protein. This may help decrease the amount of wastes in your blood and may help your kidneys to work longer.
Protein comes from two sources. You will need to get some protein each day from both of these sources:
  • Animal sources: eggs, fish, chicken, red meats, milk products and cheese
  • Plant sources: vegetables and grains

2. Sodium

Kidney disease, high blood pressure and sodium are often related. Therefore, you may need to limit the amount of sodium in your diet. One tactic to accomplish this is to learn how to read food labels so you can make lower sodium choices when you shop for foods. Sodium is a mineral found naturally in foods. It is found in large amounts in table salt and in foods that have added table salt such as:
  • Seasonings like soy sauce, teriyaki sauce and garlic or onion salt
  • Canned foods and some frozen foods
  • Processed meats like ham, bacon, sausage and cold cuts
  • Salted snack foods like chips and crackers
  • Most restaurant and take-out foods
  • Canned or dehydrated soups (like packaged noodle soup)

3. Potassium

Potassium is an important mineral in the blood that helps your muscles and heart work properly. Too much or too little potassium in the blood can be dangerous. One of the kidney’s jobs is to regulate the amount of potassium in your body and eliminate excess in the urine. When your kidneys begin to lower in function you may need to assist them by monitoring potassium in your diet. Foods that contain higher amounts of potassium are fruits and vegetables.

4. Phosphorous

Your kidneys also have the job of removing excess phosphorus from your blood. A high blood phosphorus level may cause your skin to itch and your bones to lose calcium which increases the risk for breaks. If you have CKD stage 3-5, eating fewer foods that are high in phosphorus, is very important and will help lower the amount of phosphorus in your blood.
Phosphorus is found in large amounts in the following:
  • Dairy products such as milk, cheese, pudding, yogurt and ice cream
  • Dried beans and peas such as kidney beans, split peas and lentils
  • Nuts and peanut butter
  • Beverages such as hot chocolate, beer and dark cola drinks

National Kidney Foundation!

Double Donation: Husband and Wife Each Give Gift of Life

When Marcus and Monica Gilbert decided to purchase a Charley’s Grilled Subs franchise in a food court at a Utah mall, the idea of saving two lives was not in their business plan. Yet, that is exactly what resulted. Together, this couple, married seven years, has shared many successes --owning a thriving business, raising four healthy children and, within a 16-month span, giving the gift of life through kidney donation to two individuals.
Like many married couples, Marcus and Monica balance their days between running after their four children -- Jessica, Taylor, Christian and Emma –and managing a business. Unlike many married couples, they found the time and opportunity to each donate a kidney.
It all began when Marcus hired 17-year old Juan Delgado to work at one of his Charley’s Grilled Subs franchises. Marcus was determined to help Juan and his family, knowing that he had a difficult schedule to work around while undergoing thrice-weekly dialysis treatment. He even arranged a few fundraisers at Charley’s to defray Juan’s rising medical costs. But Marcus was still not satisfied with his results and decided to take his efforts one step further and get tested to become his employee’s kidney donor. After hearing that he was a perfect match, Marcus and Juan underwent successful kidney transplant surgery in September 2008.
“I felt I was in a good spot to donate and that I couldn’t pass up on the opportunity of giving someone so young his life back,” said Marcus.
After watching her husband donate his kidney without a hitch, Monica decided she too wanted to be a living donor. So she underwent tests with the goal of donating her kidney to anyone in need.
A few weeks later, Monica was notified that she was a match for a 44-year old named Pepe Sione Lee, a husband and father from Salt Lake City. Pepe’s kidneys had failed due to diabetes and he had been receiving dialysis treatment for 18 months. On February 11, 2010, Monica successfully donated a kidney.
In recognition of Monica’s gift, Pepe and his wife are planning a luau party this summer—just around the time when Juan plans to graduate from high school. Like both their kidney recipients, Marcus and Monica have returned to their daily routines with plenty of energy, which they will use to continue to chase their children around the house.

Tuesday, April 6, 2010

Patient Champion Series: I wanted to share some of these awesome human stories that FMC has shared with me.

Age 43 • Saginaw, Mich. • Featured on March 19, 2010
The More You Do, The Better You Feel
Anthony Lee is a 43-year-old dialysis patient from Saginaw, Mich., who loves spending quality time with his family and staying active. Lee was first diagnosed with diabetes, with the end result being the failure of his kidneys. He received a kidney transplant that lasted until three years ago, and he has been on dialysis ever since.
Anthony is a busy father with two teenage daughters, and he recently decided to transition from in-center hemodialysis to home hemodialysis with Fresenius Medical Care Saginaw Riverside. He will soon start dialyzing at home and is looking forward to the flexibility and independence that home treatment will give him.
Anthony likes relaxing at home and going to church to be around positive people. He also loves being active with his daughters and enjoys playing basketball. He’s a believer in the saying, “the more you do, the better you feel,” and encourages other patients to become more active and live life to the fullest. He wants to help his fellow patients understand how CKD affects their body, and the importance of following their treatment program.

Our friend Jim Sloand to the Ways and Means Commitee.

Testimony By James Sloand, M.D., Statement


Statement of James Sloand, M.D., Medical Affairs U.S., Baxter Healthcare
My name is James Sloand, M.D. and I direct medical affairs for renal services at Baxter Healthcare for the U.S.  I have also been a practicing physician for over 30 years. Baxter’s renal business has long served the needs of people with end stage renal disease (ESRD). ESRD is the most serious form of kidney disease and occurs when the kidneys lose approximately 85-90 percent of their natural function.  Kidney disease is life threatening and requires treatment in order to remove toxins from the bloodstream.  In 1956, the company introduced the first commercially available and disposable dialyzer to act as an artificial kidney in hemodialysis.  Nearly 20 years later, Baxter pioneered peritoneal dialysis a primarily home-based treatment for ESRD patients that is used all over the world.
The development of kidney dialysis therapy and the many improvements made to it over the past several decades have vastly improved survival for patients with end-stage renal disease.  Improvements in the care of patients with kidney disease, for example, have meant that more individuals are undergoing dialysis therapy for longer periods.[1]  As such, total costs will continue to rise as the prevalence of patients on dialysis increases, (estimated to increase by 62% by 2020.[2] )
Finding a way to delay entry into dialysis and to lower the costs of car­ing by preventing hospitalizations for people with chronic kidney disease (CKD) is critical to reducing health care spending.  Patients can play an important role preventing deterioration in health once they have been diagnosed with a chronic condition. Building in patient self-management and empowerment through provider reimbursement policies may be key to reducing costs.[3]
A patient with end stage renal disease has  two different options for renal replacement therapy (dialysis) if a pre-emptive renal transplant is not available: treatment at home with either peritoneal or home hemodialysis  or by in-facility hemodialysis.  Home peritoneal dialysis is underutilized in the U.S. compared with (for example) Canada (7.6% in U.S. versus 37% in Canada in 2005).  A recent study of nephrologists indicated that if maximizing survival, wellness and quality of life were the most important factors in deciding mode for dialysis, 33% should be on PD.[4]  The underutilization of PD in the U.S. may thus have a negative impact on quality of life for patients that might otherwise use this modality and the data show that this deficiency increases costs to the Medicare program:

  • MedPAC said in a recent report "Home dialysis offers several advantages related to quality of life and satisfaction to those patients who are able to dialyze at home.”[5]  
  • The Centers for Medicare and Medicaid Services states that, "If 5 percent additional patients were to opt for home peritoneal dialysis, which provides added health and quality of life benefits….the potential savings for these 5 percent additional patients could be as much as $295 million."  (Page 20471 Final Regulation on the Medicare Conditions of Coverage for End-stage Renal Disease Patients).  [Note: these savings are through reduced hospitalizations and improved outcomes and over 10 years would result in at least $3 billion in savings.]
A lack of education about different modalities has been one of the significant reasons for underutilization in the U.S.  In fact, only 25% of patients on hemodialysis ever remember receiving information about peritoneal dialysis as an option.[6]  The provision of information to patients is also associated with greater willingness to adhere to therapies[7] and may include delayed progression to ESRD.[8]
 In 2008, the Congress added an education benefit to the Medicare program to educate patients in the final stages of kidney diseases to delay the onset of dialysis and to increase the information on dialysis options for care.  The benefit allows up to six educational sessions for Stage 4 kidney disease patients including instruction on the management of co-morbidities, with the goal of delaying the need for dialysis.  The educational sessions are also required to include a discussion of the treatment options available to patients.  The Centers for Medicare and Medicaid Services (CMS) now has responsibility for implementing this important benefit.  It is my hope that they recognize the need for a collaborative model between the physician and his staff where both contribute to the process to ensure that the therapy is as the law requires: individualized and aiding the patient in managing complications and co-morbidities of kidney failure.
I recommend that Congress further improve the management of kidney disease within the Medicare program by recognizing the direct link with the initial coverage under the Medicaid program for the low-income.  However, almost one-third of all new starts in dialysis begin in Medicaid and then transition after three months to Medicare.   Data show that Medicaid patients are less likely to have access to nephrologists and to critical information on diet.[9]  Increasing information to empower patients on how to manage their co-morbidities and significant metabolic issues-- prior to kidney failure-- is both equitable (increasing patient satisfaction) and, by reducing avoidable hospitalizations during the months immediately preceding and following the initiation of dialysis, it reduces costs for Medicaid program. 
Therefore Congress should specify that Stage 4 CKD patients should be part of targeted Medicaid case management services.[10]  In this instance, the case manager (a nurse or social worker) could ensure through community outreach that Medicaid eligibles with Stage 4 CKD have access to information on kidney disease, to kidney care providers, and they evaluate whether patients are receiving the appropriate information.  Further, similar to the recently enacted Medicare physician and practitioner model for renal education, the case manager would refer the Medicaid eligible to a physician for training on managing their co-morbidities, diet and metabolic issues, as well as the modalities of care and preparing for the appropriate access for dialysis.  It could also be a required case management activity for Medicaid managed care plans, through a case manager and through separate payments to physicians. 
In addition, prevention should be a cornerstone of all aspects of the health care system rather than an afterthought. This shift requires a fundamental change in the way providers are reimbursed in the system to reward those that are increasing the value of the health care services and reducing preventable admissions.  The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) requirement on pay for performance was an important step, as discussed further in my testimony as follows on vaccines for patients with end-stage kidney disease.
Dialysis patients have long been recognized as a vulnerable and an underserved population that would benefit from immunizations.  Since 1995, hospitalization rates for dialysis patients for infection have risen 19 percent overall, and 28% for African Americans. The rates of death due to infection are also highest among African Americans.  Studies show that vaccination will result in reduced risk of hospitalization and death from infections.  As a result, the CDC has recommended that all dialysis patients and staff be immunized to improve anti-microbial resistance. 
Patients with ESRD are under immunized (60% in 2002 and no significant improvement in the reported data since then [11]), with an even lower rate for the dual eligible population.  A CMS objective is to increase the annual ESRD patient influenza vaccination rate to 90% by 2010.  Vaccines are cost effective overall for the population over 65, reducing costs by $117 per person.[12]  Specifically, vaccinations reduce the risk of any hospitalization for hemodialysis patients by 7% (see chart below.)
Influenza vaccine delivery and effectiveness[13]
Hospitalization Reduction in Risk
-Any cause
-Influenza
-Bacteremia
-Respiratory infection
 -7%
-16%
-24%
-12%
Mr. Chairman, I request that your Committee urge CMS to include a measure concerning the percentage of vaccines, which is a national Quality Forum, for use in the pay for performance system that is required under the new dialysis payment system, effective January 2011.  The statute provides for flexibility in the measures to be used for dialysis pay for performance, but does not specifically require vaccination for influenza as a measure.  Given that spending on hospital services for patients undergoing dialysis was $7.05 billion a year in 2006, the estimated savings for an increase up to the CMS influenza vaccine target would be $150 million a year, or roughly $800 million over 5 years.  This could be a key part of aligning incentives for excellence of care for providers in the Medicare program and also for reducing disparities for vulnerable kidney patients.
Thank you for this opportunity to submit testimony for the record on health care reform and reforming the delivery system.



[1] “Technological Change and the Growth of the Health Care System”, Congressional Budget Office, January 2008.
[2] Gilbertson and Collins, USRDS (the NIH US Renal Data System).
[3] “The Healthcare Delivery System: A Blueprint for Reform, from Chapter 5, Second Generation Consumerism: Increasing Consumer Activation to Improve Health Outcomes and Lower Costs for Patients with Chronic Disease by Judith Hibbard, and Katherine Hayes, J.D., Center for American Progress
[4] Mendelssohn et al, 2001
[5] MedPAC
[6] Golper, 2001 
[7] Swatz, Robinson, Davy and Poltoski, 1999
[8] Golper, 2001
[9] Solid, Collins, USRDS, Minneapolis, Medical Research Foundation, 2007
[10] Case management is not the direct provision of medical and related services, but rather is assistance to help beneficiaries receive care by identifying needed services, finding providers, and monitoring and evaluating the services delivered.1 Targeted case management (TCM) refers to case management that is restricted to specific beneficiary groups. Targeted beneficiary groups can be defined by disease or medical
condition, or by geographic regions, such as a county or a city within a state. Targeted populations, for example, may include individuals with chronic physical or mental illness, developmental disabilities, or other groups identified by a state and approved by the Centers for Medicare and Medicaid (CMS). TCM and case management are optional services that states may elect to cover, but which must be approved by CMS through state plan amendment (SPAs).  CRS Report to Congress: Medicaid Targeted Case Management Benefits, March 27, 2008
[11] One large chain recently reported an 85% vaccination rate.
[12] The Efficacy and Cost Effectiveness of Vaccination against Influenza among Elderly Persons Living in the Community, Nichol et al, NEJM September 1994).
[13] Odds ratios for the impact of vaccinations on mortality and morbidity in hemodialysis patients during the period 1998-1999 from  “Influenza vaccine delivery and effectiveness in end stage renal disease”, Gilbertson et al, Kidney International, 2003

Sunday, April 4, 2010

New Study Suggests Peritoneal Dialysis May Offer Significant Savings to Medicare

New Study Suggests Peritoneal Dialysis May Offer Significant Savings to Medicare

by Astrid Fiano, DOTmed News Writer
The Clinical Therapeutics Journal is publishing a new paper, "The Financial Implications for Medicare of Greater Peritoneal Dialysis Use" by Nancy Neil, PhD, Steve Guest, MD, and several associates. The paper details the use of in-home versus in-center dialysis, including the patterns of dialysis utilization and the results of a budget-impact analysis that indicate if the peritoneal dialysis (PD) share of total dialysis were to increase to 15%, Medicare could yield over one billion dollars in savings over five years.

Dr. Steve Guest, Medical Affairs, Baxter Healthcare, Renal Division, McGaw Park, IL, spoke to DOTmed about the issues and findings in the paper. Dr. Guest first explained that providing care to patients with end stage renal disease (ESRD) is very costly due to the therapy itself but also for the care required to manage the oftentimes concurrent advanced co-morbidities. The overall impact to Medicare is significant as the ESRD Medicare patients represent less than 1% of Medicare enrollees but consume approximately 7% of Medicare resources as measured by payments for medical care billed to Medicare in a given calendar year.
"However, in reality," Dr. Guest said, "the differences in Medicare expenditures between peritoneal dialysis and in-center hemodialysis are very complex with resources being applied to a variety of cost centers."

For example, Dr. Guest described peritoneal dialysis as being most dependent upon disposable resources such as the dialysis solutions and supplies, used to perform the therapy at home. By comparison, in-center hemodialysis is most dependent upon fixed resources, in which investments have been made in bricks and mortar facilities, water treatment capabilities, hemodialysis machines and in-center staffing requirements. "The cost of an unused investment is high and so as not to waste those investments, they must be used to repay the capital outlay." The article is an analysis of these more comprehensive fixed resources used for in-center hemodialysis that include:

-- the facilities in which the hemodialysis is performed;
--the capital investment in the machines themselves;
--the supporting equipment necessary to treat municipal water to become medical grade water and the equipment needed to prepare the dialysate from this treated water;
--ongoing maintenance of the facilities and machines;
-- health personnel, including nurses, technicians, medical assistants, receptionists, etc.

PD does not have the same requirements for a special facility as the home is the site of care. However, Dr. Guest points out that while there is less of a capital investment for peritoneal dialysis, there are significant costs for PD therapy nonetheless: "These costs impact the dialysis providers if they are supplying the patient's dialysis supplies for peritoneal dialysis. But other economies can be realized with home therapy, such as a ratio of 20 patients to 25 patients per nurse for peritoneal dialysis compared to four to six patients per staff member for in-center hemodialysis."

Dr. Guest further detailed the findings regarding the differences in spending. "The differences in spending for hospitalization, outpatient use of erythropoiesis stimulating agents, vitamin D injectables, iron and vascular access reveal that the medical care provided to patients receiving in-center hemodialysis is more costly than that provided to patients on the home-based peritoneal dialysis therapy". Additionally, transportation costs were analyzed as in-center therapy such as hemodialysis requires the typical patient to present to the center at least three times per week for their hemodialysis treatments while peritoneal dialysis, as a home-based therapy, generally requires a patient to visit their nurse and physician only once per month. "This alone represents at least a 12-fold higher monthly cost of transportation for many in-center hemodialysis patients."

"Medicare expenditure differences in favor of peritoneal dialysis compared to in-center hemodialysis are significant" and Dr. Guest states may have been attenuated due to the fact that, in the United States, it appears that peritoneal dialysis patients are generally healthier overall than patients receiving in-center hemodialysis.
In the paper, it is mentioned that factors influencing the lesser use of PD include physician bias and lack of patient awareness due to insufficient exposure to full dialysis options education. Dr. Guest spoke of addressing the factors. "In testimony we recently submitted to the record for the House Ways and Means Committee, we provided recommendations to strengthen the education received by patients living with kidney disease who are Medicaid eligible. Medicaid accounts for one third of the starts on end stage kidney disease. As peritoneal dialysis patients rate greater satisfaction with this therapy compared to in-center hemodialysis, we point out the benefit of both increasing patient satisfaction and reducing overall Medicare costs as the Medicaid eligibles transition onto Medicare after 90 days".

In House testimony by colleague James Sloand, M.D., Medical Affairs U.S., Baxter Healthcare Dr. Sloand referenced that the lack of education about different modalities has been one of the significant reasons for underutilization in the U.S and surveys have shown that only 25% of patients on hemodialysis recall receiving information about the more cost-effective and cost-efficient peritoneal dialysis option. Dr. Sloand also commented that dialysis patients are a vulnerable and an underserved population that would benefit from improved influenza and bacterial pneumonia immunizations and greater vaccination rates could result in reduced risk of hospitalization and death from infections, which could further reduce Medicare expenditures

Saturday, April 3, 2010

Patient Champion Series: I wanted to share some of these awesome human stories that FMC has shared with me.

Harvey Jones
Age 56 • Greensboro, N.C. • Featured on March 18, 2010

Dialysis Patient Uses Voice to Inspire Peers, Legislators           


After years on the road as a singer with Al Green, Mary J. Blige, Hall & Oates, Michael McDonald and many others, Harvey Jones wasn’t about to let kidney failure stop his momentum. Rather, he embraced his diagnosis and puts all his extra energy into helping other chronic kidney disease patients.

Since beginning dialysis in June 2001, Harvey continues to sing all over the United States, as well as internationally. Over the past 19 years, he has been on in-center hemodialysis, peritoneal dialysis and received a transplant which his body rejected after 8 years. Harvey is currently on in-center hemodialysis, and is on the kidney transplant waiting list.

Being on the road, traveling from one music venue to another makes it hard for Harvey to sit still. He owns a publishing company, enjoys reading and is also a minister. In order to keep physically fit, he walks two to three miles a day.

One of Harvey's most rewarding activities is his participation in an end stage renal disease (ESRD) patient support group in Greensboro, N.C., called the Dialysis Action Committee (D.A.C.). The D.A.C. is a nonprofit which provides patient support through celebrations and picnics, kidney disease screenings with the local National Kidney Foundation chapter, and meetings with local legislators about laws that impact the ESRD community.

Harvey receives a tremendous amount of support from his family. He has been happily married for 38 years and is a father of three. He also loves his local dialysis care team and facility, and says, “I wouldn’t dialyze anywhere other than Fresenius Medical Care.”

Harvey’s goal is to assist others living with ESRD and help them embrace their diagnosis, and remain optimistic and happy. “Attitude and laughter are part of the medicine needed to help you live with kidney failure," he says.

Thursday, April 1, 2010

AWARENESS!!! It's Organ donation Month!!!

Great Basic Kidney Information from Second Opinion.

More Nxstage Users!

Another great example of the growing Home Hemodialysis population!

Licorice Chemical Question as related to Transplant!

Licorice May Block Effectiveness Of Drug Widely Used By Transplant Patients

ScienceDaily (2009-03-31) -- Chemists in Taiwan are reporting that an ingredient in licorice -- widely used in various foods and herbal medicines -- appears to block the absorption of cyclosporine, a drug used by transplant patients to prevent organ rejection. This drug interaction could potentially result in illness and death among transplant patients and others taking cyclosporine and licorice together, they caution. ... > read full article