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Dialysis world news


7 Tips for Traveling With a Parent on Dialysis - Huffington Post PDF Print

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Today, kidney disease is the 9th leading cause of death in the United States. About 23 million Americans currently suffer from chronic kidney disease, and nearly 400,000 of them need dialysis. Most use hemodialysis, a procedure that can be done either at home or in a specialized facility and requires the patient to be connected to a large machine for hours at a time, several days a week.

If your parent uses hemodialysis, you may think that such a treatment regimen means that his or her traveling days are done. But that doesn't have to be the case! With a little bit of planning, it's quite possible for your parent to travel safely and continue treatments while on vacation.

First, though, check with your parent's doctors to make sure that he or she is healthy enough for travel. Then look into your parent's insurance situation to determine what coverage he or she has. (For example, Medicare and other insurance might not cover dialysis or related doctor's fees at dialysis centers other than your parent's usual location.) If your parent's existing insurance plans do not provide coverage at other facilities, you'll want to inquire about the costs at the destination center.

Once you get the doctors' approval and confirm your parent's insurance coverage for a trip, it's time to start making plans! The following suggestions will help you plan a trip that incorporates your parent's hemodialysis treatments.

1. Don't do home hemodialysis while on vacation.
Even if your parent usually does home hemodialysis, treatment centers may be preferable while traveling because they eliminate the need to haul all of your parent's dialysis equipment with you (and risk damaging it). Discuss with your parent and his or her current dialysis care team whether home dialysis or in-center treatment is the best option during your trip. If your parent decides to stick with home dialysis while on the road, make sure you know the location of the center closest to where you'll be staying. When you reach your destination, contact the staff at that center to let them know that you're in the area and to find out what their emergency procedures are so you know what to do if your parent has a problem.

2. Don't book a flight before finding a hemodialysis center that can accommodate your parent.
Many dialysis centers are booked months in advance, particularly at popular destinations and during peak tourist season and holidays. So before you purchase any plane tickets (or make other arrangements that are nonrefundable or difficult to change), make sure there's a treatment center at your destination that can schedule your parent during your trip. (Your parent's usual dialysis center may be able to help you find centers in other locations.)

3. Have your parent's usual dialysis center fax his or her medical file to the center at your destination well in advance of your trip.
Before you leave home, confirm with the destination center that it received the file. Hemodialysis centers usually require the following documents:

  • medical history (including a recent physical exam)
  • results for recent lab work, EKG tests, and chest x-rays
  • dialysis prescription form
  • records for the 3 to 5 most recent treatments
  • description of dialysis access type
  • special needs or dialysis requirements
  • insurance information
  • list of all prescription medications (including any that must be given during dialysis treatment)
  • contact information for all of your parent's doctors and his or her usual dialysis center

4. Schedule a pre-dialysis visit at the center for shortly after you arrive at your destination.
Never show up unexpectedly at a center, even for non-treatment visits--always make appointments in advance. Use your pre-appointment visit to confirm your parent's appointment schedule and verify that this center has your parent's medical file. You don't want to be figuring out those details while your parent is waiting to receive treatment. So be sure to identify and handle any problems well in advance.

5. Bring a copy of your parent's medical file to the dialysis center.
Even if the center at your destination has received your parent's records from his or her usual center, having all the necessary paperwork on hand can expedite treatment if your parent has any problems while onsite.

6. Research local hospitals before you go.

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Although the dialysis center your parent visits while on vacation can offer assistance if he or she becomes ill, it's a good idea to know where nearby hospitals are in case your parent needs emergency care. Prepare a list of them before your trip, and be sure to include hospitals near your hotel as well as in areas where you'll be touring.

7. Always carry your parent's medical paperwork with you.
When on vacation, there's a chance your parent may exceed his or her normal activity levels, and exertion can trigger medical issues. So be sure to carry your parent's medical information with you at all times in case he or she requires emergency care.

When traveling with any aging parent, remember not to overdue the activities and to build in plenty of down time so everyone can relax. When traveling with a parent who uses dialysis, you may need to take things even easier, because dialysis can make people tire more readily. With good information and plenty of planning, though, dialysis won't prevent you and your parent from having a terrific vacation together!

(For additional information about dialysis, visit the National Kidney Foundation website at www.kidney.org.)

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Patients evacuated from dialysis center in Chesapeake fire - The Virginian-Pilot PDF Print
By Katherine Hafner
The Virginian-Pilot
© August 14, 2015

CHESAPEAKE

More than two dozen patients were evacuated from the DaVita Great Bridge Dialysis Center this afternoon after a small fire started in the building.

Firefighters arrived at 745 N. Battlefield Blvd. in Greenbrier across from the hospital around 12:50 p.m. and found a small fire in an overhead light fixture.

Crews brought the fire under control in 10 minutes.

Twenty-six patients were evacuated from the building until being allowed to reenter at 1:18 p.m.

Division Chief Simone Gulisano said there were chairs set up outside to accommodate the patients as much as possible.

He said they are still investigating the cause of the fire.

This is the third fire in Chesapeake in two days, following two in Deep Creek this morning and Thursday afternoon.

 

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Most ESRD Patients Not Referred for Transplant - MedPage Today PDF Print

Action Points

Only about one in four patients with end-stage renal disease in Georgia were referred for kidney transplant evaluation by their dialysis facility from 2005 to 2011, according to a study published in the Journal of the American Medical Association.

Of those referred, only about one in five made it onto the national deceased-donor waiting list, reported lead investigator Rachel Patzer, PhD, of Emory University in Atlanta, and colleagues.

"For most of the 600,000 patients in the United States with end-stage renal disease (ESRD), kidney transplantation represents the optimal treatment, providing longer survival, better quality of life, and substantial cost savings compared with dialysis," Patzer and colleagues wrote.

"Despite these benefits, kidney transplantation is not available to all patients with ESRD, owing to the paucity of available organs, as well as long-standing racial/ethnic, socioeconomic, sex, age, and geographic disparities in access to kidney transplantation," the investigators said in the report.

A referral for evaluation at a transplant center is usually required to begin the transplantation process, but the proportion of patients referred in the United States is unknown. There is no source of national data on referral rates, Patzer told MedPage Today.

Patzer and colleagues decided to investigate referral rates in Georgia, the state with the lowest kidney transplantation rate, in order to shed some light on this issue. "This study is unique because no one has ever looked at data on this level before," Patzer said.

The investigators collected data on more than 15,000 adult patients with ESRD at 308 Georgia dialysis facilities from 2005 to 2011. The data were obtained from the United States Renal Data System. The researchers then linked this information to kidney transplant referral data collected from transplant centers in Georgia during the same time period.

The study found that 28% of the ESRD patients were referred for transplantation within one year of starting dialysis. Referral rates varied widely across dialysis centers, from 0% to 75%. The median within-facility percent of patients referred was 24%.

Compared with dialysis facilities with the highest rates of referral, those with the lowest rates were more likely to treat patients from high-poverty neighborhoods (absolute difference 21.8%; 95% CI 14.1% to 29.4%; P<0.001), to have a higher patient to social worker ratio (mean 61.2 versus 38.8; P<0.001), and to be non-profit (difference 17.6%; 95% CI 7.7% to 27.4%; P=0.001).

Patients not referred were more likely to be older (difference 5.7 years; 95% CI 5.3 to 6.1; P<0.001), to be white (absolute difference 5%; 95% CI 3.4% to 6.6%; P<0.001), and to be female (difference, 3.8%; 95% CI 2.1% to 5.6%; P<0.001).

Of the patients referred, 21.5% were put on the donor waiting list within one year of their referral. The factors associated with referral were often not the same as those associated with being waitlisted, the researchers noted. For example, sex and age were not significantly associated with waitlisting, and black patients (versus white) were less likely to be waitlisted (OR 0.77; 95% CI 0.64 to 0.93; P not reported).

"These finding may have implications for health policy makers, researchers, clinicians, and patients. Low facility level referral for transplantation, as well as the variability in referral across Georgia facilities, suggests that standardized guidelines are needed for the content and duration of a patient-clinician educational discussion regarding treatment options at start of dialysis," the researchers concluded.

"The 28% figure seemed low to us," Patzer told MedPage Today. "There aren't any absolute contraindications to transplant. Given that transplant is the best treatment option, we would think the majority of patients would be referred."

Having more patients referred and put on the waiting list for transplant would not necessarily just increase the wait time for a limited supply of donor organs, Patzer argued. "It's not a zero sum game," she said.

For example, eligible patients would have the option of trying to find a living donor among family or friends. And transplant centers might be more aggressive about the organs they select, she said.

"Nephrologists, social workers, and nurses in dialysis facilities should be having conversations with patients about transplant as early as possible. The earlier you can get a referral, the better," Patzer said.

Increasing referral rates may not be enough to ensure better patient outcomes, said transplant surgeon Dorry Segev, MD, PhD, of Johns Hopkins University, and colleagues in an editorial.

"In light of these findings, efforts to improve access should not only focus on improving rates of dialysis center referral for kidney transplantation but also on identifying and targeting barriers for the 80% of referred patients who ultimately did not achieve access," Segev and colleagues wrote.

"These findings underscore the complexities involved in obtaining access to care and should serve as a reminder that it may not be sufficient to provide a referral for care in the absence of guidance and support through the process," they said.

This research was supported by the National Institute on Minority Health and Health Disparities.

The authors disclosed no relationships with industry.

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Rockwell Medical, Inc. (RMTI) Files Form 4 Insider Buying : Raymond Dennis ... - Insider Trading Report PDF Print

Rockwell Medical, Inc. (RMTI): Raymond Dennis Pratt , VP of Drug Development of Rockwell Medical, Inc. purchased 5,000 shares on Aug 13, 2015. The Insider buying transaction was disclosed on Aug 14, 2015 to the Securities and Exchange Commission. The shares were purchased at $11.54 per share for a total value of $57,675.44.

Currently the company Insiders own 5.5% of Rockwell Medical, Inc. Company shares. In the past six months, there is a change of 0% in the total insider ownership. Institutional Investors own 34.4% of Company shares. During last 3 month period, 25.61% of total institutional ownership has changed in the company shares. Rockwell Medical, Inc. (NASDAQ:RMTI): The stock price is expected to reach $ 16.6 in the short term. The number of analysts agreeing with this consensus is 5. The higher estimate for the short term price target is at $26 while the lower estimate is at $4. The standard deviation of the price stands at $7.99. The company shares have rallied 25.52% from its 1 Year high price. On Jul 17, 2015, the shares registered one year high at $18.90 and the one year low was seen on Dec 15, 2014. The 50-Day Moving Average price is $15.83 and the 200 Day Moving Average price is recorded at $12.05. Rockwell Medical, Inc. (NASDAQ:RMTI) : On Monday heightened volatility was witnessed in Rockwell Medical, Inc. (NASDAQ:RMTI) which led to swings in the share price. The shares opened for trading at $14.15 and hit $14.53 on the upside , eventually ending the session at $14.09, with a gain of 0.86% or 0.12 points. The heightened volatility saw the trading volume jump to 533,528 shares. The 52-week high of the share price is $18.8999 and the company has a market cap of $708 million. The 52-week low of the share price is at $8.095 . Rockwell Medical, Inc., formerly Rockwell Medical Technologies, Inc., manufactures hemodialysis concentrate solutions and dialysis kits, and it sells, distributes and delivers these and other ancillary hemodialysis products primarily to hemodialysis providers in the United States, as well as internationally primarily in Asia, Latin America and Europe. Hemodialysis duplicates kidney function in patients with failing kidneys also known as End Stage Renal Disease (ESRD). ESRD is an advanced-stage of chronic kidney disease (CKD) characterized by the irreversible loss of kidney function. Its dialysis solutions (also known as dialysate) are used to maintain life, removing toxins and replacing nutrients in the dialysis patient’s bloodstream. As of December 31, 2011, it was licensed and was developing renal drug therapies. During the year ended December 31, 2011, it acquired an abbreviated new drug application (ANDA) for a generic version of an intravenous Vitamin-D analogue, calcitriol.

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Child Cancer Survivors at Increased Risk for Neoplasm in Adulthood - Renal and Urology News PDF Print
August 14, 2015 Increased risk for treatment-related subsequent neoplasms even beyond age 40 years.
Increased risk for treatment-related subsequent neoplasms even beyond age 40 years.

(HealthDay News) -- Survivors of childhood cancer are at increased risk for treatment-related subsequent neoplasms (SNs), even after age 40 years, according to a study published online Aug. 10 in the Journal of Clinical Oncology.

Lucie M. Turcotte, M.D., M.P.H., from the University of Minnesota Medical School in Minneapolis, and colleagues examined SN incidence beyond the age of 40 years in childhood cancer survivors. Among 14,364 survivors, 3,171 had attained an age of 40 years or older at the time of last contact.

The researchers identified 679 SNs that were diagnosed in patients aged 40 years or older, including 196 subsequent malignant neoplasms (SMNs), 419 nonmelanoma skin cancers, 21 nonmalignant meningiomas, and 43 other benign neoplasms. The cumulative incidence of new SNs and SMNs occurring after age 40 years was 34.6 and 16.3%, respectively, at age 55 years. The likelihood of receiving a diagnosis of SMN after age 40 years was increased compared with the general population (standardized incidence ratio [SIR], 2.2; 95% confidence interval [CI], 1.9 to 2.5). 

Among SMNs, risk was increased for breast cancer, renal cancer, soft tissue sarcoma, and thyroid cancer (SIRs [95 percent CIs]: 5.5 [4.5 to 6.7], 3.9 [2.0 to 7.5], 2.6 [1.5 to 4.4], and 1.9 [1.0 to 3.5], respectively). In multivariable analysis, female sex and therapeutic radiation exposure correlated with increased risk of SMN (relative risks, 1.9 and 2.2, respectively; both P < 0.001).

"These data suggest the need for life-long monitoring and should inform anticipatory guidance provided to survivors of childhood cancer," the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

Sources

  1. Turcotte, LM; Whitton, JA; Friedman, DL; et al. Journal of Clinical Oncology, published online before print August 10, 2015; doi: 10.1200/JCO.2015.60.9487.
  2. Applebaum, MA and Cohn, SL. Journal of Clinical Oncology, published online before print August 10, 2015; doi: 10.1200/JCO.2015.62.7703.

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