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God Help You. You're on Dialysis

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cschwab:
The Atlantic
By Robin Fields/ProPublica

Every year, more than 100,000 Americans start dialysis. One in four of them will die within 12 months

amullin:
Robin Fields is on Public Broadcast radio, as is Dr. Straube. It is about time that the "dirty" little secret is out. Robin has done an excellent job......one that many newspapers were afraid of doing.

I am proud to know her.

cschwab:
It looks like all we have to do is copy the Italian system.  Is it done yet?

It was good to see Larry's story getting out.  He has been through a lot and people ought to know.

Larry Hall and DialysisEthics

I went ahead and put the Propublica story on the front page of the website.

cschwab:
Industry titan DaVita deems assessment "disappointing"

By Steve Raabe
The Denver Post
Posted: 11/10/2010 01:00:00 AM MST
Updated: 11/10/2010 01:49:32 AM MST

The ProPublica article on the U.S. dialysis industry is misleading and misinterprets data, said officials of Denver-based DaVita Inc., the nation's largest dialysis provider.

While the mortality rate of U.S. kidney patients is higher than in some other industrialized countries, the rate has steadily fallen, and patients generally receive high-quality care, said Dr. Allen Nissenson, chief medical officer of DaVita.

Nissenson said the article is "profoundly disappointing. It took some information and did not clearly explain it or (present) it in a way that people could understand the issues."

DaVita operates 1,582 dialysis clinics, with a workforce of about 34,000, including 749 in Colorado.

The firm last year moved its corporate headquarters from El Segundo, Calif., to metro Denver, becoming Colorado's ninth Fortune 500 company.

DaVita plans to begin construction next year on a $101 million headquarters building in the Central Platte Valley at the west end of the 16th Street Mall.

DaVita officials noted that the mortality rate of U.S. dialysis patients has fallen by 8.5 percent since 2002, from 231.3 per 1,000 patients that year to 211.7 in 2007, the most recent year reported by the U.S. Renal Data System.

The U.S. has comparatively higher death rates, Nissenson said, for two reasons: Patients tend to come into the dialysis system already sicker than those in other countries, and the U.S. has higher proportions of blacks and Latinos

cschwab:
Golly gee, didn't see this coming  :thumbsdown: :

"The U.S. has comparatively higher death rates, Nissenson said, for two reasons: Patients tend to come into the dialysis system already sicker than those in other countries (continued)"

Tell you what DaVita, you will have to convince the following folks what you say is true before I would even consider changing my mind - about what I've been hearing for over ten years:

"The cumulative survival of Japanese hemodialysis patients is more than 2.5 times better than that of dialysis patients in the United States (U.S.). The difference is particularly pronounced in older patients, being 4 times better in patients over the age of 50 years. The mortality in U.S. patients has increased from 10 to 25% over the last three decades, but has remained stable at around 10% in Japan. There is no obvious difference in patient selection. The Japanese accept almost as high a proportion of diabetic patients as does the United States, and the mean age of incident patients is higher in Japan. Renal transplantation, virtually absent in Japan, should increase mortality in U.S. dialysis patients by removing patients with the highest probability of survival, but even if one adds surviving transplant patients and studies prevalent populations, the survival rate is much better in Japan. Genetic factors are unlikely to explain differences in mortality, as older Americans live much longer than older Japanese. We speculate that the difference lies in the practice of dialysis. Patients in the United States are generally treated by much faster and shorter dialysis than in Japan. This puts a severe burden on the cardiovascular system of older patients, leading to the poorer survival rate. Japanese physicians also appear to be better trained in dialysis and to spend more time with their patients. The nursing shortage in the United States may also contribute to the increased mortality. Whatever the explanations, the U.S. dialysis community must work to equal and, hopefully, surpass the now superior survival of Japanese dialysis patients."
http://www.ncbi.nlm.nih.gov/pubmed/19379344?dopt=Abstract  

(above article by Dr. Christopher Blagg

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