'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

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]

See Social Networking can be Very Good!

Conn. mayor donates kidney to Facebook friend

AP – Kidney recipient Carlos Sanchez poses for a photograph at his home in East Haven, Conn., Wednesday, April …

By STEPHANIE REITZ, Associated Press Writer Stephanie Reitz, Associated Press Writer – Wed Apr 21, 7:32 pm ET

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!

Thanks, 
 http://organdonor.gov/

Michelle Castrogiovanni

Division Special Events Manager

National Kidney Foundation

Serving Upstate New York

NKF Healthy Tips!!! Toss the Salt!

TOSS THE SALT!
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health benefits from reducing salt
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healthier life!
What is 1/2 teaspoon of salt?
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Helpful Hints to being Salt Smart:
♦ Toss your salt shakers!
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♦ When eating out, ask for foods
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If PD fails: Think about home HD

• Print this article

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 – 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:

• Dialysis Needle Fear: Easing the Sting²⁴
• Dialysis Needles, Self-Cannulation, and the Buttonhole Technique²⁵

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.

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.

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

The Good Dialysis Index

By 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.

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

Marian Carr

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.

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

Tanysha Pitts

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.