Dialysis industry news

Stories from the dialysis comunity across the globe.



Technique Treats Central Venous Occlusion in Dialysis Patients - Renal Business Today PDF Print

SAN FRANCISCO—A radiofrequency (RF) wire technique appears to be a safe alternative for managing benign chronic central venous occlusions when conventional techniques have failed, according to findings presented at the 37th Annual Scientific Meeting of the Society of Interventional Radiology.

“We have been the pioneers on this,” stated study investigator Marcelo Guimaraes, MD, Associate Professor of Radiology at the Medical University of South Carolina in Charleston. “We have been doing this now for three years and we have the largest experience in the world with this procedure. We only treat symptomatic patients or patients who are on dialysis and the AV [arteriovenous] graft or fistula is showing malfunction.”

Dr. Guimaraes and his colleagues analyzed the outcomes of 31 patients (15 female) ranging in age from 35 to 78 years who were treated between June 2008 and January 2011. In these patients, previous attempts at recanalization using mechanical catheter/wire techniques had failed. The patients presented with a swollen arm and/or face secondary to benign central venous occlusions (7 subclavian veins, 19 brachiocephalic veins, and 5 superior vena cava veins) related to tunneled catheters. Simultaneous upper extremity (brachial approach) and central venograms (femoral approach) defined the central occlusion site.

The investigators used the PowerWireTM RF (Baylis Medical, Canada) wire, which was advanced within a 5-Fr KMP catheter. With this approach, a pre-stent 4 mm balloon angioplasty was followed by 10-12 mm stent placement. If the RF wire puncture was inadequate, the clinician pursued a new location. Clinical and venogram follow-ups occurred at 30 days post-treatment and again at three, six, and 12 months.

The RF wire technique successfully treated 29 patients. The procedure was aborted in two patients. In one case, the problem was due to hemothorax, which was successfully treated with a chest tube without clinical repercussions. All of the successfully treated patients had resolution of symptoms after a mean follow-up of seven months. Two of the 29 patients experienced stent occlusion within 30 days; the remaining stents were patent at nine months. The patients were asymptomatic in all 27 cases.

“We are now getting nephrologists referring patients from other parts of the country,” Dr. Guimaraes told Renal & Urology News. “The complications have been very rare.”

The real key to the success with this technique is very close follow-up, Dr. Guimaraes said. “This is like when you buy a car,” he said. “We know there will be need for maintenance but we don't know if it will be in three months or in three years.”

Thus, he and his colleagues explain to patients that they need to return for a venogram as soon as they experience symptoms, he said.

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Kidney Dialysis Leaders Gather to Discuss Home Dialysis Improvement - Renal Business Today PDF Print

WASHINGTON—Today, more than 50 invited leaders in the field of kidney dialysis, including patients, clinicians, industry, and policymakers, assembled in Washington, DC for the first-ever National Summit on Home Dialysis Policy.

The group came together to identify common concerns and opportunities to drive appropriate utilization of home dialysis and identify pathways for collaborative action. Home dialysis, including peritoneal dialysis and home hemodialysis, are alternatives to in-center treatment, which requires patients to visit a clinic or hospital three to four times per week.

While peer-reviewed medical literature reflects broad support for home dialysis, including improved outcomes associated with greater consistency of treatments, enhanced patient satisfaction, and improved quality of life, less than 10 percent of U.S. dialysis patients receive treatment at home, according to a recent Medicare Payment Advisory Commission report to Congress.

Dr. Rajnish Mehrotra, a Summit delegate and speaker, said of the event, "The need for home dialysis in the U.S. will continue to rise with the growing numbers of End Stage Renal Disease (ESRD)  patients. Now is a crucial time to assess what more we can do to better enable patients access to all the treatment options they require and home dialysis is an important modality."

In a letter to Summit delegates, the honorary congressional  co-chairs of the Summit ,Tom Marino (R-PA), Jim McDermott (D-WA), Jesse Jackson Jr. (D-IL), and John Fleming (R-LA), applauded participants for coming together, noting, "The importance of this conversation has only been heightened in recent years, as policymakers work to constrain rising health care costs while ensuring that all individuals, particularly those in high-risk, low access populations, continue to have access to high quality care."

Organizers of the event will issue a report following the event highlighting the day's key discussions and areas of consensus policy recommendations. For additional information on the event, the steering committee or any of the materials presented, please visit www.homedialysissummit.org .

The Summit was made possible by the generous support of the following organizations: Affymax/Takeda; American Society of Nephrology; Baxter; DaVita, Inc.; Dialysis Patient Citizens; National Kidney Foundation; Northwest Kidney Centers; NxStage Medical; Renal Physicians Association; and Satellite Healthcare.

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Prosecutor: Patients terrified by nurse's actions - The Associated Press PDF Print
Prosecutor: Patients terrified by nurse's actions

LUFKIN, Texas (AP) — A former Texas nurse accused of killing five kidney dialysis patients by injecting them with bleach caused others to fear for their lives after they witnessed some of the injections, a prosecutor told jurors during closing arguments Thursday.

Two patients testified that they saw Kimberly Clark Saenz inject bleach into the IV lines of two other patients, Angelina County District Attorney Clyde Herrington reminded jurors. Prosecutors allege that Saenz, 38, caused the patients' deaths in April 2008 by injecting bleach into their dialysis lines at a clinic in Lufkin, a city about 125 miles northeast of Houston.

The two patients "saw something that was unusual and scared them to death. Had it not been for (the patients) we might not be here," Herrington said.

But defense attorney Ryan Deaton told jurors that Saenz is innocent and is being targeted by the clinic's owner for faulty procedures at the facility, including improper water purification. Deaton also suggested that clinic officials have fabricated evidence against Saenz.

The clinic where Saenz worked is owned by Denver-based health care giant DaVita Inc.

"All we have here today is Ms. Saenz being a scapegoat for the sins of a Fortune 500 company," Deaton said.

If convicted of capital murder, Saenz could face the death penalty. Her trial, in its fourth week, began March 5.

She didn't take the stand in her own defense. But in a recording played at trial, the former nurse could be heard testifying before a grand jury that she felt "railroaded" by the clinic and "would never inject bleach into a patient."

Saenz is charged with one capital murder count that accuses her of killing as many as five patients. She's also charged with five counts of aggravated assault for injuries to five other patients.

Investigators testified that they found Internet searches on Saenz's computer about bleach poisoning in blood and whether bleach could be detected in dialysis lines.

Bleach is commonly used to disinfect plastic lines and other dialysis equipment at the clinic. Saenz's attorneys said she was spotted measuring bleach into a syringe because she wanted to put the right amount into cleaning water.

Former DaVita employees who testified for prosecutors told jurors that they never used syringes instead of measuring cups to ensure the proper amounts of bleach were being used in cleaning solutions. Dialysis patients spend up to three days a week tethered for hours to a machine that filters their blood because their kidneys can't do so.

Saenz was charged a year after the clinic was closed for about two months in the wake of a rash of illnesses and deaths in April 2008. Emergency crews had been called to the clinic as many as 30 times that April and made at least 19 runs. Seven of the calls were for cardiac problems.

There had been only two calls during the previous 15 months, according to the Texas Department of Health Services.

DaVita Inc. investigated along with local, state and federal agencies.

A Food and Drug Administration report found some samples linked to some victims tested positive for bleach while others showed bleach "may have been present at one time."

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Kentucky, Louisville fans duke it out at dialysis clinic - Atlanta Journal Constitution PDF Print

For the AJC

Authorities said the Kentucky-Louisville basketball rivalry boiled over at a Kentucky dialysis clinic when one patient punched another during an argument about the two teams.

According to Georgetown police, the altercation began Monday with a verbal exchange between the 68-year-old Kentucky fan and the 71-year-old Louisville fan.

The Kentucky fan, who was receiving treatment,  flipped off the Louisville fan, who responded with a punch to the face.

Police were called, but the Kentucky fan declined to file charges.

The Wildcats and Cardinals, hated rivals, meet Saturday in New Orleans for a spot in the NCAA championship game Monday. Some wags are calling it the biggest sporting event in the state's history.

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Life saving donation - Hernando Today PDF Print

In 2009, Michael Durr became ill in Panama he tried to just work through it. Being retired Navy personnel and a busy real estate developer in Panama, his work ethic pushed him onward.

But when he couldn't go on any further and feeling gravely ill, he was taken to a hospital in Panama, where he was told that he had pneumonia for starters. When he flew back home to the U.S., he was immediately placed in the ICU, where he later was diagnosed with kidney failure. He began dialysis, initially at a hospital, then at a dialysis center later on in 2009 in Spring Hill. A year later, he was able to start dialysis at home.

Durr was placed on the national waiting list for a kidney transplant to await a kidney donation from an organ donor who had passed away. Over 80,000 people were listed on the national waiting list at the time. He was told that it could take between three to five years to find a donor match.

From the most recent data, there is an average of 2.5 million deaths in the U.S., if each of those people chose to donate their organs, there would be no shortage and many people may not die waiting for an organ transplant.

National Donate Life Month is celebrated in April.

An average of 18 people die each day waiting for organ transplants, because there is such a shortage of donated organs, according to the U.S. Department of Health & Human Services statistics.

During that time, he bought a drag race car. Even then, Durr was not going to let life's troubles get in his way of living life to the fullest. He was going to fulfill his life's "to-do" list.

May 2011, Durr and his wife of 35 years, Gigi, were told of the National Kidney Registry paired exchange program from the Lifelink of Florida staff at Tampa General Hospital. In this paired exchange program, a living donor is matched with a person who is need of a kidney through its common registry of donors.

Founded by the National Kidney Registry's founder and president, Garet Hil, the living donor, usually a family member or friend of someone in need of kidney donation, "pays it forward" and donates a kidney in the name of their loved one who is need of a kidney donation. In return, their loved one is matched with a donor through the same living donor common registry, usually receiving a kidney within six months.

Gigi and Michael had to find a living kidney donor because the waiting list from a deceased donor was so long.

Gigi immediately started a rigorous four months of medical testing to see if she could qualify to be a kidney donor. The four months of medical tests and exams were assessing to see whether she would experience any adverse effects of what is known at this time after donating a kidney.

"They had to make sure I was healthy enough so that I would not be compromised if I were to donate a kidney", explained Gigi.

September 2011, Gigi had passed all the tests and was cleared to be a living kidney donor, placed on the Nation Kidney Registry's common registry. She was scheduled for surgery at Tampa General Hospital last December to donate her kidney.

Through the common registry, a match was found for Gigi's husband right away. They were ecstatic. Michael was scheduled for surgery at Tampa General Hospital to receive his new kidney the same day as Gigi's surgery.

Later, they learned much to their surprise, they were part of the longest kidney donation chain, linking 60 people and 30 living kidney donors from across the country.

The National Kidney Registry and the longest kidney donation chain was recently featured on ABC's World News with Diane Sawyer and in a New York Times article last month.

Michael's kidney donor, Becky Clark, from Sarasota, was scheduled for surgery to donate her kidney the same day. Gigi and Becky were able to meet each other a couple days later while they were in the hospital, recovering from their surgeries.

"We just cried together and hugged each other. And Becky still stays in contact with Michael through Facebook, asking him how her kidney is doing", explained Gigi.

Gigi and Michael Durr are embracing life together and moving onward with their active lives without the hindrances of dialysis and illness. They have plans to go back to Panama and to drag racing, two of their passions in life.

The need is so great for organ donors, Gigi and Michael are fortunate to have found a match through the living donor program. Michael could have died waiting on that list for a deceased organ donor.

Consider signing up as an organ donor today and help to save the lives of those waiting for an organ transplant.

For more info about organ donations, visit organdonor.gov or and to register as an organ donor, go to donatelifeflorida.org.

INFORMATION BOX:

For further info about the living kidney donor- paired exchange program, contact:

Candace Skelton, RN

Living Donor Coordinator, Lifelink of Florida

(813) 844-5667 or (813) 844-5650 or (800) 844-9302

National Kidney Registry

(800) 936-1627

www.kidneyregistry.org

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