***Pump Speeds and Mortality***
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- Written by: Super User
Do We Need to Abandon High Ultrafiltration Rates in America?
By Peter Laird, MD
Dialysis practices around the world differ significantly from the practice patterns observed in America and many have long believed this is in part the explanation for our higher dialysis mortality.
I recently spoke with a manager of a dialysis unit and his experience with horrified Japanese patients who couldn't believe the blood flow rates used in America compared to Japan. Japan, Europe, Australia and New Zealand have long recognized the survival benefits of longer, slower and gentler dialysis compared to our American style violent sessions.
***Davita proves the need for the Stark Law***
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- Written by: Super User
Rivals wary of dialysis giant DaVita's aggressive business style
By Jennifer Brown
The Denver Post
Posted: 07/14/2009 01:00:00 AM MDT
Updated: 07/14/2009 08:40:38 AM MDT
News that Fortune 500 company DaVita Dialysis is moving its headquarters to Denver socked its competitors like a punch in the gut. To its rivals, the kidney-care giant is a bully armed with high-powered attorneys who use lawsuits as tools to intimidate.
DaVita executives counter that they are simply strong competitors — they act as aggressors only when doctors or nurses or other dialysis companies break promises and double-cross them.
Either way, a string of DaVita-filed lawsuits around the country — with two major battles boiling in Denver and Colorado Springs — shed light on the ruthless competition over dialysis patients in an industry that costs Medicare alone more than $8 billion per year. For years, DaVita's competition in Colorado's two largest cities was almost nonexistent.
Failing safety standards at dialysis centers put Georgians at risk
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- Written by: Super User
Credit: National Institutes of Health
Editor’s note: This story has been updated to include comments by the new owners of the Hapeville and Stone Mountain clinics.
At Hapeville Dialysis Center, patient deaths surged more than six times above the national average in 2018, yet administrators failed to investigate why, according to state inspection reports.
In Stone Mountain, clinical staff at Veritas Dialysis mishandled potentially infectious waste and used dialysis machines that had broken parts for months.
And at Gwinnett Dialysis Center in Lawrenceville, a nurse in 2020 stored blood specimens inside a refrigerator that stored patient medications.
These centers for the treatment of end-stage kidney disease are among the 45% of Georgia dialysis centers that have fallen so short on patient safety, care and other standards that regulators decided to dock their pay this year.
Read more: Failing safety standards at dialysis centers put Georgians at risk
Large Dialysis Organizations Run-Ins with The Law and the Media
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- Written by: Super User
(see John Oliver and friends' take on kidney dialysis after the following)
!!!!!!!Out Now!!!!!!!
How to Make a Killing: Blood, Death and Dollars in American Medicine
***See author's interview with NorthWest Passages on YouTube***
(from the author's website)
How did a lifesaving medical breakthrough become a for-profit enterprise that threatens the people it’s meant to save?
Six decades ago, researchers achieved the impossible: a treatment that made kidney failure a manageable condition instead of a death sentence. And yet, in the hands of a predatory medical industry, this triumph led to skyrocketing costs and worsening care.
A gripping microcosm of American health care gone wrong, How to Make a Killing recounts how the optimism of the 1950s and 1960s—when transplants and early dialysis machines offered hope—gave way to anguished debates about the ethics of rationing (and profiting from) life-saving care. After Congress made renal disease the only “Medicare for All” condition, Big Dialysis proliferated, and the Hippocratic oath gave way to the profit motive.
A triumph of investigative research, Tom Mueller’s book features an unforgettable cast of characters: CEOs who dress as Musketeers to exhort more aggressive profit-seeking, nephrologist insiders who reveal the substandard care this causes, and heroic patients who risk their lives to reveal the truth.
Tom Mueller's books and articles
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(updated 2023)
(Click the image for information on finding a living donor, home dialysis, and other info)
The following video and articles highlight what happens when a CEO can't tell the difference between a Taco Bell and a dialysis clinic (that observation was made by the comedian John Oliver):
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Profit and Loss: America on Dialysis
This December 2020 Scientific American series of articles points out many of the multitude of problems affecting kidney dialysis:
*When large corporations come in hospitalizations will go up and treatment quality will go down.
*The dialysis companies have figured out how to game the system and increase their already outrageous profits by getting dialysis patients off Medicare and into private insurance where private insurance can be gouged! This results in higher insurance premiums for the rest of us.
*Also pointed out are the downsides of having nephrologists have a financial stake in dialysis clinics. There is also some discussion of the other side of the argument.
*Another article points out the racial disparities in dialysis. However one doctor does provide a bright spot.
*An uplifting article discusses how the pool of available kidneys has been increased with the use of things like hepatitis C infected kidneys.
*An article discusses how dialysis patients have a hard time accessing palliative and hospice care.
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Dialysis: Last Week Tonight with John Oliver
The link provided below brings up a quick 24 minute video which provides an excellent introduction to the goings-on and history of kidney dialysis through the anesthesia of humor. Kent Thiry and Davita play a prominent role in this clip about an area of healthcare that has been on the forefront of bad medicine. It led one commentator to state: "We are paying the most to get the least." That seems to be American healthcare in a nutshell.":
Credit: John Oliver on Youtube
John Oliver and dialysis on Youtube
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Bonus - Click for Diabetes Care
(a bit more encouraging - sort of)
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The Strangest Show on Earth!
Former CEO Kent Thiry liked to call Davita a "Village" where he was the mayor. But was it as Dr. Peter Laird of Lancaster CA called it: “the Village of the Damned”? This hard-hitting article by Luc Hatlestad might help you decide:
credit: Eddie Guy and 5280 magazine
Read more: Large Dialysis Organizations Run-Ins with The Law and the Media
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