(The following posts are what I've been sending Mr. Bailey)
Jerome,
Even though I wasn't chosen for the congressional visit, it was great to hear you have more than enough people willing to go!
I hope you don't mind if I give my 2 cents worth on what I was hoping will be addressed. I've watched the goings-on in kidney dialysis for about 12 years now and have some strong opinions on what ought to change.
The appalling sky-high mortality rate is the bottom-line that has kept me from turning away all these 12 years. Our mortality rate vs. a country like Italy sums it up for me:
US vs Italy graph:
http://dialysisethics2.org/open_images/mortality.jpgHow best to address this? From about day one until now I've heard longer, slower dialysis would cut significantly into our mortality rate. This has been from some very reliable sources, I've seen other articles that say otherwise - but the sources seemed less than reputable.
Here are few quotes:
"In Japan and Germany, one of the pay for performance targets for dialysis is that
85% of dialyzors must be getting at least 4 hours of treatment 3x/week (this would translate to 2 hours x 6 days a week). I think that would be an excellent goal worth working toward here, particularly in light of the DOPPS (Dialysis Outcomes & Practice Patterns Study) data among 22,000 or so dialyzors that found a 30% drop in the risk of death for folks who got at LEAST 4 hours of treatment. IMHO, there is no excuse for anyone to be getting less than this, regardless of body size. It is not possible to get too much dialysis (though it is possible to remove too much water and leave people feeling wretched--this is actually quite common)." http://forums.homedialysis.org/showthread.php/2667-Dialysis-Industry-May-Expand-as-Study-Sways-Medicare"
Dr. Belding Scibner, inventor of the Scribner Shunt:
"Short hemodialysis sessions have great appeal only to the uninformed dialysis patient and to for-profit dialysis centers"
http://www.therenalnetwork.org/qi/resources/HDP.pdfDr. Carl Kjellstrand, recipient of a Lifetime Achievement award in Hemodialysis:
"Homeostasis cannot be maintained with short, fast dialysis. Just as speed on the road kills, so it does in hemodialysis."
http://www.dialysisethics2.org/index.php/Our-Concerns/dr-carl-kjellstrand.htmlDrs. Christopher Blagg, former director of Northwest Kidney Centers and Dr. Carl Kjellstrand:
"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.
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