• Latest
  • Trending
  • All
  • Featured Urology
  • Female Urology
  • Urologic Oncology
  • What is Urology?
  • Pediatric Urology
  • Urology

Not all kidney patients treated equal: Differences in care for patients beginning on dialysis

September 8, 2020
Yoga for Prostate Cancer: Best Yoga exercises to combat prostate growth in men

Yoga for Prostate Cancer: Best Yoga exercises to combat prostate growth in men

November 14, 2022
New treatment can more than double life expectancy for people with prostate cancer: doctor

New treatment can more than double life expectancy for people with prostate cancer

November 14, 2022
Study finds that use of yoga app can reduce urinary incontinence

Study finds that use of yoga app can reduce urinary incontinence

November 9, 2022
Urinary Incontinence: Types and Treatments

Urinary Incontinence: Types and Treatments

November 9, 2022
Low Rates of PSA Screening Linked to Increase in Metastatic Prostate Cancer

Low Rates of PSA Screening Linked to Increase in Metastatic Prostate Cancer

November 4, 2022
Can Erectile Dysfunction Drugs Reduce Dementia Risk?

Can Erectile Dysfunction Drugs Reduce Dementia Risk?

November 4, 2022
New PSA test examines protein structures to detect prostate cancers

New PSA test examines protein structures to detect prostate cancers

November 2, 2022
A better way to image metastatic prostate cancer

A better way to image metastatic prostate cancer

November 2, 2022
Newly discovered protein may protect kidney cells from injury

Newly discovered protein may protect kidney cells from injury

November 2, 2022
A person’s diet, acidity of urine may affect susceptibility to UTIs

A person’s diet, acidity of urine may affect susceptibility to UTIs

November 2, 2022
Award-winning agent developed for prostate cancer diagnosis and treatment

Award-winning agent developed for prostate cancer diagnosis and treatment

November 2, 2022
New treatment for polycystic kidney disease

New treatment for polycystic kidney disease

November 2, 2022
Wednesday, November 30, 2022
Urology Today
  • Home
  • Featured Urology
    Yoga for Prostate Cancer: Best Yoga exercises to combat prostate growth in men

    Yoga for Prostate Cancer: Best Yoga exercises to combat prostate growth in men

    Study finds that use of yoga app can reduce urinary incontinence

    Study finds that use of yoga app can reduce urinary incontinence

    Urinary Incontinence: Types and Treatments

    Urinary Incontinence: Types and Treatments

    Low Rates of PSA Screening Linked to Increase in Metastatic Prostate Cancer

    Low Rates of PSA Screening Linked to Increase in Metastatic Prostate Cancer

    Kidney failure impacts survival of sepsis patients

    Kidney failure impacts survival of sepsis patients

    Urine-based test improves on PSA for detecting prostate cancer

    Urine-based test improves on PSA for detecting prostate cancer

    Unemployment linked to rise in prostate cancer deaths

    Unemployment linked to rise in prostate cancer deaths

    Unemployment linked to rise in prostate cancer deaths

    Advanced viral gene therapy eradicates prostate cancer in preclinical experiments

    prostate cancer

    Recurrence of prostate cancer detected earlier with innovative PSMA-ligand PET/CT

    Two major studies strengthen case for prostate cancer drug before chemotherapy

    Two major studies strengthen case for prostate cancer drug before chemotherapy

    Trending Tags

    • Donald Trump
    • Future of News
    • Climate Change
    • Market Stories
    • Election Results
    • Flat Earth
  • Lifestyle
    • All
    • Female Urology
    • Male Urology
    • Pediatric Urology
    Yoga for Prostate Cancer: Best Yoga exercises to combat prostate growth in men

    Yoga for Prostate Cancer: Best Yoga exercises to combat prostate growth in men

    Study finds that use of yoga app can reduce urinary incontinence

    Study finds that use of yoga app can reduce urinary incontinence

    Urinary Incontinence: Types and Treatments

    Urinary Incontinence: Types and Treatments

    New PSA test examines protein structures to detect prostate cancers

    New PSA test examines protein structures to detect prostate cancers

    A better way to image metastatic prostate cancer

    A better way to image metastatic prostate cancer

    Award-winning agent developed for prostate cancer diagnosis and treatment

    Award-winning agent developed for prostate cancer diagnosis and treatment

    New treatment for polycystic kidney disease

    New treatment for polycystic kidney disease

    Urine-based test improves on PSA for detecting prostate cancer

    Urine-based test improves on PSA for detecting prostate cancer

    Unemployment linked to rise in prostate cancer deaths

    Advanced viral gene therapy eradicates prostate cancer in preclinical experiments

    Two major studies strengthen case for prostate cancer drug before chemotherapy

    Two major studies strengthen case for prostate cancer drug before chemotherapy

    Trending Tags

    • Golden Globes
    • Mr. Robot
    • MotoGP 2017
    • Climate Change
    • Flat Earth
No Result
View All Result
Urology Today
No Result
View All Result
Home Urology / Nephrology News

Not all kidney patients treated equal: Differences in care for patients beginning on dialysis

by Urology Today
September 8, 2020
in Urology / Nephrology News
0
491
SHARES
1.4k
VIEWS
Share on FacebookShare on Twitter

Kidney disease patients insured by some federally sponsored national health care organizations are more likely to undergo an important predialysis procedure than patients with other types of insurance, according to a study appearing in an upcoming issue of the Journal of the American Society Nephrology (JASN). The results may provide insights into ways to improve kidney-related care for patients before they go on dialysis.

For patients whose kidneys no longer work, hemodialysis performs the work of the kidneys. Experts recommend creating an arteriovenous fistula (AVF), to connect a vein and artery and allow access to the vascular system. An AVF provides a long-lasting site through which blood can be removed and returned during the dialysis procedure, which patients must undergo 3-4 times per week.

While AVF use for hemodialysis access is safe, cost-effective, and associated with improved survival in kidney disease patients, only a minority of US patients start hemodialysis with an AVF (13.7% in 2008).

Frank Hurst, MD (Walter Reed Army Medical Center and F. Edward Hebert School of Medicine) and his colleagues evaluated the use of AVFs in federally sponsored national health care organizations such as the Departments of Veterans Affairs (DVA) and Department of Defense (DoD). Dr. Hurst and his team searched the United States Renal Data System (USRDS) database to identify patients who initiated hemodialysis between 2005 and 2006. They found that patients who received predialysis kidney care were 10 times as likely to begin dialysis with an AVF compared with patients who did not receive such care. Patients with DVA/DoD insurance were 40% more likely to initiate dialysis with an AVF compared with patients with other types of insurance. Specifically, 27.2% of patients with DVA/DoD insurance initiated hemodialysis with an AVF, compared with 18.5% of patients reporting employer-group insurance, 16.7% of patients with “Other” insurance, 15.6% of patients with Medicare, 13.0% of patients with Medicaid, and 8.2% of patients who reported no insurance. The analysis also revealed that patients who initiated hemodialysis at a DoD facility were twice as likely to use an AVF.

Experts are attempting to increase the use of AVFs through initiatives such as the Fistula First Breakthrough Coalition, whereby the Centers for Medicare & Medicaid Services, End Stage Renal Disease Networks, and the entire kidney community are working together to ensure that every suitable patient will receive the most optimal form of vascular access. Dr. Hurst’s findings show that despite these efforts, AVF use is still highly dependent upon a patient’s type of health insurance prior to the initiation of dialysis.

“Further study of these federal systems may identify practices that could improve processes of care across healthcare systems to increase the number of patients who initiate hemodialysis with an AVF,” the authors wrote. They added that while AVF use is more frequent in DVA/DoD patients, the proportion of these patients who initiate hemodialysis with an AVF is still far too low.

Study co-authors include Kevin Abbott, MD (Walter Reed Army Medical Center and F. Edward Hebert School of Medicine); Dominic Raj, MD (George Washington University); Mahesh Krishnan, MD (Davita Clinical Research); Carlos Palant, MD (Washington DC VA Medical Center and George Washington University School of Medicine); Lawrence Agodoa, MD (National Institutes of Health); and Rahul Jindal, D, PhD (George Washington University, Walter Reed Army Medical Center, and Brookdale University Medical Center).

In an accompanying editorial, Steve Schwab, MD and Kennard Brown, PhD (University of Tennessee Health Science Center) expressed dismay that AVF placement before dialysis, which requires treatment by both a nephrologist and a vascular surgeon, is not covered by Medicare, which supports most coverage for dialysis. “We now have a public policy that treats a catastrophic illness such as renal failure but does not act to prevent or ameliorate that catastrophe earlier,” they wrote. The authors advocate for amending policy guidelines so that patients can benefit from seeing specialists early in the course of their disease.

###

Disclosures: Dr. Krishnan is employed by Davita Clinical Research, an independent provider of dialysis services in the United States. All other authors reported no financial disclosures. Dr. Schwab and Dr. Brown, the authors of the editorial, reported no financial disclosures.

The views expressed in this article are those of the authors and do not reflect the official policy of the U.S. Government, the National Institutes of Health, the Department of Defense, the Department of Army, or Walter Reed Army Medical Center.

The article, “Arteriovenous Fistulas among Incident Hemodialysis Patients in Department of Defense and Veterans Affairs Facilities” (doi 10.1681/ASN.2010010025) and editorial, “Immature Public Policy for Vascular Access” (doi 10.1681/ASN.2010070771) will appear online at http://jasn.asnjournals.org/ on August 12, 2010.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, the American Society of Nephrology (ASN) is the world’s largest professional society devoted to the study of kidney disease. Comprised of 11,000 physicians and scientists, ASN continues to promote expert patient care, to advance medical research, and to educate the renal community. ASN also informs policymakers about issues of importance to kidney doctors and their patients. ASN funds research, and through its world-renowned meetings and first-class publications, disseminates information and educational tools that empower physicians.

###
Contact: Shari Leventhal
.(JavaScript must be enabled to view this email address)
202-416-0658
American Society of Nephrology

Share196Tweet123Share49
Urology Today

Urology Today

  • Trending
  • Comments
  • Latest

Urethral pressure profilometry

September 8, 2020
Low Rates of PSA Screening Linked to Increase in Metastatic Prostate Cancer

Low Rates of PSA Screening Linked to Increase in Metastatic Prostate Cancer

November 4, 2022
Kidney failure impacts survival of sepsis patients

Kidney failure impacts survival of sepsis patients

November 2, 2022

Genetic basis of genitourinary malformations

0
Embryogenesis -Paediatric Urology

Embryogenesis -Paediatric Urology

0
Upper urinary tract

Upper urinary tract

0
Yoga for Prostate Cancer: Best Yoga exercises to combat prostate growth in men

Yoga for Prostate Cancer: Best Yoga exercises to combat prostate growth in men

November 14, 2022
New treatment can more than double life expectancy for people with prostate cancer: doctor

New treatment can more than double life expectancy for people with prostate cancer

November 14, 2022
Study finds that use of yoga app can reduce urinary incontinence

Study finds that use of yoga app can reduce urinary incontinence

November 9, 2022
Urology Today

Copyright © 2022 Urology Today.

Navigate Site

  • About
  • Advertise
  • Privacy & Policy
  • Contact

Follow Us

No Result
View All Result
  • Home
  • Featured Urology
    • Urologic Oncology
    • Female Urology
    • Pediatric Urology
    • What is Urology?
  • Lifestyle

Copyright © 2022 Urology Today.

Welcome Back!

Login to your account below

Forgotten Password?

Retrieve your password

Please enter your username or email address to reset your password.

Log In