ESRD Network 15, 17 to join health care consulting organization HealthInsight - NephrologyNews.com
The Intermountain End Stage Renal Disease Network Inc., which holds the contracts for ESRD Network 15 and 17, has announced plans to affiliate with HealthInsight, a nonprofit, community-based health care consulting organization, to create the HealthInsight ESRD Alliance. The partnership aims to improve the effectiveness, efficiency, and reach of quality health care for patients and providers across the western United States. Participants in the new HealthInsight ESRD Alliance will retain their corporate identities and will continue to use their current names alongside the HealthInsight ESRD Alliance name.
Headquartered in Salt Lake City, HealthInsight has more than 40 years of experience assisting front-line providers and engaging health care stakeholders. As a Centers for Medicare & Medicaid Services Quality Innovation Network Quality Improvement Organization (QIN-QIO) HealthInsight serves Nevada, New Mexico, and Utah, as well as in Oregon through a partnership with Acumentra Health. The organization works with health care providers, stakeholders and patient communities to transform care and improve care delivery and patient outcomes.
Intermountain ESRD Network Inc. represents CMS ESRD Networks 15 and 17, respectively and has provided services to CMS as an ESRD Network organization since 1978. Intermountain ESRD Network Inc. was awarded a second contract to operate ESRD Network 17 in 2006 and both Networks contracts have been operated successfully under common management and governance since that time.
Network 15 serves Arizona, Colorado, Nevada, New Mexico, Utah and Wyoming. Network 17 serves Northern California, Hawaii, Guam, Mariana Islands-Saipan and American Samoa.
“The Intermountain ESRD Network is excited to partner with HealthInsight. Our organizations share a passion for bringing quality care to the patients we serve and believe that this partnership will further expand the capabilities for both organizations,” said Darlene Rodgers, executive director of Networks 15 and 17.
Under the terms of the agreement, Intermountain ESRD Network, Inc. will become a subsidiary and function as a division of HealthInsight by Jan. 1, 2016.
Clear cell papillary renal cell carcinoma: A review - Abstract - UroToday
The disease concept of clear cell (tubulo) papillary renal cell carcinoma (CCP-RCC) as a distinct subtype of renal cell carcinoma has been recently established.
First described in the setting of end stage renal disease, this tumor type is more frequently recognized and encountered in a sporadic setting. In this article, we provide an overview of the recent understanding of this tumor. Macroscopically, tumors are well circumscribed with well-developed tumor capsule. Histologically, the tumor cells are cuboidal to low columnar cell with clear cytoplasm and papillary and tubulo-papillary configuration. Immunohistochemically, tumor cells generally show diffuse expression for cytokeratin 7, CA9 (cup-shaped pattern), HIF-1, GLUT-1 and high molecular weight cytokeratin, but negative for AMACR, RCC Ma and TFE3. CD10 is negative or focally positive in most tumors. Genetically, this tumor has no characteristics of clear cell RCC or papillary RCC. Prognostically, patients with CCP-RCC behave in an indolent fashion in all previously reported cases. In conclusion, although this tumor has been integrated into recent International Society of Urologic Pathology Classification of renal neoplasia, both aspects of disease concept and clinical behavior are yet to be fully elucidated. Further publications of large cohorts of patients will truly help understand the biologic potential and the molecular underpinnings of this tumor type.
Kuroda N, Ohe C, Kawakami F, Mikami S, Furuya M5 Matsuura K, Moriyama M, Nagashima Y, Zhou M, Petersson F, López JI, Hes O, Michal M, Amin MB. Are you the author?
Department of Diagnostic Pathology, Kochi Red Cross Hospital Kochi, Japan; Department of Pathology, Kansai Medical University Hirakata Hospital Osaka, Japan; Department of Diagnostic Pathology, Kobe University Hospital Kobe, Japan; Division of Diagnostic Pathology, Keio University Hospital Tokyo, Japan; Department of Molecular Pathology, Yokohama City University Graduate School of Medicine Yokohama, Japan; Department of Molecular Pathology, Oita University Oita, Japan; Division of Diagnostic Pathology, Tokyo Women's Medical University Hospital Tokyo, Japan; Department of Pathology, New York Medical Center NY, USA; Department of Pathology, National University Hospital System Singapore, Singapore; Department of Pathology, Cruces University Hospital, BioCruces Health Research Institute, University of the Basque Country (EHU/UPV) Barakaldo, Bizkaia, Spain; Department of Pathology, Charles University in Prague, Faculty of Medicine in Plzen Pilsen, Czech Republic; Department of Pathology & Laboratory Medicine, Cedars-Sinai Medical Center Los Angeles, CA, USA.
Reference: Int J Clin Exp Pathol. 2014 Oct 15;7(11):7312-8.
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Panel to review 5-star rating system for dialysis facilities - NephrologyNews.com
A panel made up of renal community members and other medical professionals will meet as part of a Technical Expert Panel later this month to review the methodology used for the controversial 5-Star rating system for dialysis facilities.
The Centers for Medicare & Medicaid Services (CMS) contracted with the University of Michigan Kidney Epidemiology and Cost Center (UM-KECC) to review the rating system, which was launched as part of the Dialysis Facility Compare website in January despite protests from the renal community.
CMS has been criticized because it did not involve the renal community in developing the methodology for the rating system and because the performance of dialysis clinics based on other quality measures doesn’t match the 5-star ratings.
The 17-member panel will meet April 27-28 in Baltimore. Members include patients, dialysis providers, and outside professionals with expertise in statistics and public health.
- Paul T Conway, president of the American Association of Kidney Patients
- Joanna Y. Galeas, patient advocate, Renal Support Network
- Joseph D. Karan, patient advocate and director of Education, National Kidney Foundation of Florida
- Allen R. Nissenson, MD, chief medical officer, DaVita HealthCare Partners
- Franklin Maddux, MD, executive vice president for Clinical and Scientific Affairs, Fresenius Medical Care
- John (Jack) Reynolds, vice president and patient ambassador, Dialysis Patient Citizens
- Tonya L. Saffer, MPH, Senior Health Policy Director, NKF
- David M. White, chair on the Patient Advisory Committee and Medical Review Board member, Mid-Atlantic Renal Coalition
- Sumi Sun, MPH, director of Applied Research and Data Analysis, Satellite Healthcare
Researchers and biostatisticians on the panel include:
- Richard J. Cook, PhD, MS, Tier I Canada Research Chair (renewal) of Statistics and Actuarial Science, University of Waterloo
- J. Richard Landis, PhD, professor of Biostatistics and professor of Statistics at the University of Pennsylvania (Wharton School)
- Jane F. Pendergast, PhD, professor of Biostatistics, Duke University
- Catherine Sugar, PhD, director of Semel Institute Statistics Core University of California, Los Angeles and associate professor for the Departments of Biostatistics, Statistics and Psychiatry, UCLA.
UM-KECC staff said additional conference calls may be held after the meeting with members to finalize recommendations.
More information, including the complete list of panel members, is available in the “downloads” section at the bottom of the CMS TEP website: http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/TechnicalExpertPanels.html
Boston Scientific Resumes Renal Denervation Trials, Broadens Participant Pool - Med Device Online (press release)
By Suzanne Hodsden
Boston Scientific has enrolled the first of 100 patients in REDUCE-HTN: REINFORCE, a new clinical trial to test its renal denervation system, Vessix. The company believes that by studying a broader pool of participants, it can answer some questions that have stymied other renal denervation studies.
Renal denervation technology (RDT) is targeted at cases of chronic hypertension that are resistant to pharmaceutical intervention, and works by selectively disabling renal nerves with radio frequency and blocking the mechanisms that cause blood vessels to constrict.
While supported by many experts in theory, RDT systems have yet to produce conclusive results in clinical trials. As yet, no system has been approved by the FDA for clinical use in the U.S.
The principal investigators of the Boston Scientific study believe that variables in medications and high-risk patients clouded results of previous investigations. In a recent press release, they announced their intention to study a broader range of hypertensive patients in hopes of shedding light on the true efficacy of renal denervation.
“Previous results of renal denervation studies have been affected by a focus on patients with the difficult-to-define condition of treatment resistant hypertension, made even more complex by uncertainties regarding their use of hypertension medications. We need to find clarity, and we believe this innovative study design will enable us to do so,” said Michael Weber, co-principal investigator and professor of medicine at the State University of New York (SUNY).
Boston Scientific’s proposed study will look at 100 patients who are not on medication, and will focus primarily on the mean reduction in average 24-hour ambulatory systolic blood pressure at eight weeks post randomization.
The Vessix system, acquired by Boston Scientific in 2012, uses a multi-electrode bipolar catheter and balloon-based approach, and treatment time is approximately 30 seconds. The system is already approved for sale in Australia, New Zealand, Europe, the Middle East, and certain Asian markets.
Boston Scientific projected that the first results from the new study would be available in early 2016.
Both Medtronic and Boston Scientific have made good on their promises to renew efforts to study RDT and are ahead of the schedule projected by Forbes in February.
Earlier this month, Medtronic announced that it had begun enrolling patients in a newly redesigned trial, which will involve 200 patients, both those receiving medication and those who are not, to compare results from both groups.
ReCor Medical, a startup based in California and Amsterdam, also announced that it has received a $15 million dollar investment from Otsuka Holdings to begin an investigation of its RDT technology, which will be conducted in the U.S. and Europe.
According to CDC estimates, 70 million American suffer from chronic hypertension, and over half of those cases are resistant to drugs. If left uncontrolled, hypertension can induce potentially fatal conditions such as atrial fibrillation, stroke, heart failure and kidney failure.
A recent article in the Minneapolis Star Tribune cited analysts who say there is a projected multi-billion dollar global market waiting for clinically proven RDT systems.
Image credit: Boston Scientific