Home Dialysis Central update
[Vol.6, No.10, October 20, 2009]
It's just about winter here in Wisconsin, but we're keeping warm working on comments on the new MIPPA proposed rule. Show your support for home options with our "Ask me about home dialysis" buttons, available from our Home Dialysis Central store!
MEI offers comments on MIPPA Proposed Rule
We've pored through all 450+ pages of the rule, and our comments focus exclusively on how the rule will impact patients—including home training. If you'd like a PDF of our draft comments (we'll submit them after the Town Hall meeting on 10/23), email schatell@meiresearch.org. Please copy or echo them as you see fit!
Webinar: Join NN&I for Homeward Bound on Weds. 10/21
You won't want to miss speakers on the impact of the proposed rule on home treatment like Dr. John Moran, Stacy Cigliana, Linda Upchurch, Dr. Joe Pulliam, and our own Bill Peckham. Sign up for NN&I's free webinar at 2pm Central. Register here!
Pipeline technology: Nanodialysis!
How about a wearable artificial kidney that cleans the blood with four types of nanoparticles—and works for a year at a time? Dutch researchers hope to start animal testing next year. Read about it and watch the video (NOTE: An ad comes up first).
Home hemo in the heartland
We love it when home dialysis makes the news, and this time an article features two patients from Kansas. Read their stories!
Network 14 project exposes home treatment myths
Home patients can't own pets, need TONS of storage space, don't get their treatments paid for, and it's "not fair" to tell people about treatments not offered at their clinic. Right? WRONG! Read the results of ESRD Network 14's home dialysis education project. (NOTE: Scroll down to "Home Sweet Home.")
Icodextrin PD fluid causes less weight gain
We're not surprised to learn that PD fluid that doesn't contain dextrose (sugar) is less likely to cause weight gain! A study of 183 PD patients found weight gains after 3 years (88% of it fat) among those using standard fluid, and significantly less weight gain in an icodextrin group. Read the abstract.
PD catheter placement: Surgeon or nephrologist?
Does who places a PD catheter make a difference in complications or catheter survival? Not really, finds a new Greek study that looked at 152 patients who received 170 catheters. Only early leakage (easily treated) was more likely with nephrologist placement. Read the abstract.
More dialysis: Better survival
A hot-off-the-presses study in Kidney International compared each of 94 patients on nocturnal HD and 43 on short daily HD to 10 matched controls on standard HD. Those on nocturnal HD had significantly better survival, and those on daily had better (but not significantly) survival. Oddly, hospitalization rates were similar. Download the full-length PDF.
Nocturnal HD normalizes smooth muscle cells
Blood vessel calcification is an all-too-common problem among people on dialysis. On standard HD, fewer smooth muscle cells grow inside the blood vessels, and more of them die. Switching from standard to nocturnal restored normal cell growth—and also lowered blood pressure, and PTH and phosphate levels. Read the abstract.
Wanda & Kenny Wilson have more freedom & control with home dialysis
When Wanda's kidneys failed, she didn't even know what a nephrologist was! Now, she and her husband are doing nocturnal home hemo, 5 nights a week, and enjoying a much more normal lifestyle. Read their story.
Topic of the month: Keep the options open!
It's here! You may recall from our Q&A that we've been waiting for Medicare to release a Notice of Proposed Rulemaking. Now they have, and it tells us what they plan to put in a new "bundled" payment for dialysis treatments. Comments are due on November 16, and hearing from YOU can make a difference. Learn what can affect you and how to make your comment. Read the article.
Will Medicare pay for home dialysis equipment that a patient is temporarily not using?
Click here to learn the answers to this & other questions about Medicare payment for PD and home hemo.
Read all about it!
Review home dialysis-related news. This week's stories include:
- CMS releases first draft of the ESRD bundled payment formula
- Kidney disease linked to depression even in early stages?
- For kidney disease patients, staying active might mean staying alive
- Acute kidney injury patients more likely to need dialysis within 5 years
Featured link: MATCH-D 2.0
CMS now requires documentation of a talk with patients about treatment options—including why someone is not a candidate (if they're not). Our new, updated Method to Assess Treatment Choices for Home Dialysis (MATCH-D) version 2.0 has checkboxes, notes space, and signature lines so it can be included in the medical record. Check it out!