From the Denver Post

[cschwab]

Kidney-dialysis titan DaVita defends patient care, business practices

By Christopher N. Osher, Jennifer Brown and Michael Booth
The Denver Post
Posted: 05/07/2011 11:24:05 PM MDT
Updated: 05/08/2011 11:39:18 AM MDT

A dialysis treatment machine at DaVita Lowry Dialysis Center in Denver, Colorado. ( Joe Amon, The Denver Post)
DaVita, a Fortune 500 company, is building a $101 million, 14-story corporate headquarters in Lower Downtown. Over the past decade, the kidney dialysis company has amassed 1,612 dialysis centers. (Andy Cross, The Denver Post)

The relocation to Denver last year of kidney-dialysis titan DaVita was good news to a local economy battered by the recession.

But as the Fortune 500 company's $101 million, 14-story corporate headquarters rises in Lower Downtown, it continues to battle questions about its business practices.

Chief among the accusations, raised in federal investigations and lawsuits, is that DaVita overused a lucrative anemia drug called Epogen in order to receive higher government reimbursements.

The Food and Drug Administration has warned since 2007 that the drug, routinely used to help anemic patients on dialysis, also can increase the risk of death when used at certain levels.

DaVita officials energetically defend their company and say they never put patients at risk.

They say that doctors ultimately decide how much Epogen to use and that the company's protocols on the drug's use are aimed solely at keeping patients healthy. They said a corporate recommendation in December to use less of the drug was tied to evolving science and not to a reduction in government reimbursements that took effect three weeks later.

"DaVita has done, in my view, a spectacular job of improving

[cschwab]

DaVita lets patients reuse filters, now a less-common practice in industry

By Jennifer Brown
The Denver Post
Posted: 05/08/2011 01:00:00 AM MDT


DaVita continues to allow patients to reuse their filters

[angieskidney]

Great article! I have always been against reuse but probably because it sounded like such a risk to someone (me) who has never been in a dialysis unit that even HAS reuse (they don't do that in Canada as far as I know). I do know a lot of patients are for reuse so I am always interested in more articles about this weighting the pros and cons.

"because their bodies react better to filters already coated with their proteins." I never knew about that. I would be interested in learning more about this.

Perhaps it is not so much the reuse itself but in the staff and risk of contamination as it seems that reuse in the hands of incompetent staff could result badly but if in the right hands saves money is just as good.

I would be interested in seeing stats as I know there have been a lot of occurrences with contamination but seems worse in some areas than others. I would NOT want to end up with some disease or infection due to staff's incompetence and giving me the wrong reuse filter. As long as staff's mistakes are as high as they are, I never want to use reuse myself. Dialysis patients are already at high risk of developing cardiovascular disease and other issues. Not like they need any MORE issues added to their health!

Maybe I feel strongly about this because I ended up with Kidney Disease in the first place due to a doctor's incompetence (not caused by him but the eventual cause of my kidney disease could have easily been prevented and never led to kidney disease at all if the doctor had done his job right). I know money talks but it is our health at stake and I don't think money is worth more than health!

Like a school counselor used to say to me all the time:

Health is Wealth!

NOT THE OTHER WAY AROUND!

Thanks for sharing this article Chris!

DaVita officials said that "in the rare instances of a patient getting the wrong dialyzer, the risk of infection transmission is virtually nil due to sterilization procedures in place."

I feel like saying to DaVita officials, "Say that to the families of those who died!"

[cschwab]

"because their bodies react better to filters already coated with their proteins." I never knew about that. I would be interested in learning more about this.

This sounds like it is the argument I heard from way back when before the synthetic membranes in dialyzers came along.  If this is true, I don't know if I would trust somebody who is trying to use info that is outdated and ancient:

From a 2004 study:
"The synthetic membranes are more biocompatible than their cellulosic predecessors so the reuse-associated medical benefit probably disappeared. The rationale for reusing synthetic membrane dialysers thus became purely financial."
http://www.dialysisethics2.org/forum/index.php?topic=57.0

in the rare instances of a patient getting the wrong dialyzer, the risk of infection transmission is virtually nil due to sterilization procedures in place.

That looks to be just plain wrong:
"More troubling is the patient who was exposed to Hepatitis C, because neither that virus nor AIDS can be killed with current sterilization techniques"
http://www.dialysisethics2.org/forum/index.php?topic=604.0

Somebody is not looking very credible.

[angieskidney]

From a 2004 study:
"The synthetic membranes are more biocompatible than their cellulosic predecessors so the reuse-associated medical benefit probably disappeared. The rationale for reusing synthetic membrane dialysers thus became purely financial."
http://www.dialysisethics2.org/forum/index.php?topic=57.0

"More troubling is the patient who was exposed to Hepatitis C, because neither that virus nor AIDS can be killed with current sterilization techniques"
http://www.dialysisethics2.org/forum/index.php?topic=604.0

And that is why you are needed Chris! Very good information! I hope more see this!

[cschwab]

Guess at least I've got a long memory for this!  

[angieskidney]

Guess at least I've got a long memory for this!  

Yeah I don't know how you can keep it all straight over the years