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e f f e c t i v e + t r e a t m e n t + f o r + n a t i o n a l + h e a l t h c a r e + a u t h o r i t i e s h o w e v e r + b e c a u s e + o f + a + s h o r t a g e + o f + d o n o r + o r g a n s + a n d + s u i t a b l e + l i v i n g + d o n o r s % 2 c + k i d n e y + d i a l y s i s + i s + s t i l l + t h e + m o s t + c o m m o n l y + u s e d + t r e a t m e n t h o w e v e r % 2 c + d e s p i t e + t h e + a v a i l a b i l i t y + o f + a + h o m e + t r e a t m e n t + p r o c e d u r e + c a l l e d + p e r i t o n e a l + d i a l y s i s + % 2 8 p d % 2 9 + a l m o s t + 9 0 + p e r + c e n t + o f + p a t i e n t s + c u r r e n t l y + u s e + h a e m o d i a l y s i s + % 2 8 h d % 2 9 % 2 c + u s u a l l y + a t + a + h o s p i t a l + o r + c l i n i c f r o m + a + p a t i e n t + p e r s p e c t i v e % 2 c + p d + i s + s e e n + a s + m o r e + f l e x i b l e + a l l o w i n g + p a t i e n t s + t o + t a k e + a + g r e a t e r + r o l e + i n + m a n a g i n g + t h e i r + c a r e t h e + n e e d + f o r + a + s u r v e y + o n + p a t i e n t + c h o i c e % 2 2 p a t i e n t + i n v o l v e m e n t + h a s + a + p o s i t i v e + e f f e c t + o n + q u a l i t y + o f + l i f e + a n d + p a t i e n t + s a t i s f a c t i o n % 2 c % 2 2 + c e a p i r + v i c e + p r e s i d e n t + l a r s + e n g b e r g + t o l d + p a r t i c i p a n t s + a t + t h e + e v e n t % 2 2 p a t i e n t s + h a v e + a + d i f f e r e n t + p e r s p e c t i v e % 2 c + s o + t h e i r + i n v o l v e m e n t + c a n + a f f e c t + t h e i r + c l i n i c a l + o u t c o m e + a n d + h e l p + c o m p l e m e n t + t h e + k n o w l e d g e + o f + h e a l t h + p r o f e s s i o n a l s % 2 2 % 2 2 a + p a t i e n t + s u r v e y % 2 c + l i k e + t h e + o n e + b e i n g + d i s c u s s e d + t o d a y % 2 c + i s + o n e + w a y + o f + i n v o l v i n g + p a t i e n t s + a n d + a l l o w s + u s + t o + f o c u s + o n + a r e a s + o f + a c t i o n + w i t h i n + t h e + h e a t h + s e r v i c e % 2 2 e n g b e r g + a d d e d + t h a t + p o l l s + s u c h + a s + t h e + r e c e n t + c e a p i r + s u r v e y + c a n + e s p e c i a l l y + b e n e f i t + p a t i e n t s + a s + t h e + d e c i s i o n s + t h e y + m a k e + o n + t h e i r + t r e a t m e n t + c o u l d + h a v e + a + % 2 2 v e r y + s t r o n g + i m p a c t % 2 2 + o n + t h e i r + d a i l y + l i v e s h a r d + d a t a + o n + t r e a t m e n t + o p t i o n s + w a s + e s s e n t i a l + i f + o r g a n i s a t i o n s + l i k e + c e a p i r + w a n t e d + t o + b e t t e r + p r o m o t e + t h e + i n t e r e s t s + o f + k i d n e y + p a t i e n t s + s a i d + e n g b e r g + % 2 2 w e + n e e d + t o + u n d e r s t a n d + i f + w e + w a n t + t o + b e t t e r + r e p r e s e n t + p a t i e n t s % 2 2 t h e + d e b a t e + h e a r d + o f + t h e + m o v i n g + e x p e r i e n c e + o f + p e t e r + f a h y % 2 c + a + 2 0 - y e a r - o l d + d u b l i n - b a s e d + k i d n e y + p a t i e n t + w h o + s p o k e + o f + t h e + w a y + t h e + d i s e a s e + h a d + t r a n s f o r m e d + h i s + l i f e f a h y + o p t e d + f o r + h o m e - b a s e d + p d + d i a l y s i s + % 2 8 n o r m a l l y + d o n e + a s + h e + s l e e p s % 2 9 + a s + h e + f e l t + i t + w o u l d + b e + l e s s + d i s r u p t i v e + a n d + a l l o w + h i m + t o + l e a d + a + r e a s o n a b l y + n o r m a l + l i f e + a s + a + t e e n a g e r + a t + h o m e + r a t h e r + t h a n + i n v o l v e + s e v e r a l + t r i p s + a + w e e k + t o + a + h o s p i t a l h e + s a i d % 2 c + % 2 2 i + h a v e + b e e n + r e c e i v i n g + t r e a t m e n t + s i n c e + t h e + a g e + o f + 1 5 + b u t + j u s t + h o p e + i + c a n + l e a d + a s + n o r m a l + a + l i f e + a s + p o s s i b l e % 2 2 % 2 2 i t % 2 7 s + i m p o r t a n t + t h a t + p e o p l e + a r e + i n f o r m e d + o f + a l l + t h e + o p t i o n s + s o + t h e y + c a n + c h o o s e + a + t r e a t m e n t + t h a t + s u i t s + t h e i r + l i f e s t y l e % 2 2 f i n d i n g s + a n d + c h a l l e n g e s k a j s a + w i l h e l m s s o n % 2 c + a + s e n i o r + c o u n c i l l o r + w i t h + p a + f i r m + e d e l m a n % 2 c + p r e s e n t e d + d e t a i l s + o f + t h e + s u r v e y % 2 c + w h i c h + w a s + s u p p o r t e d + b y + b a x t e r + h e a l t h c a r e % 2 c + s a y i n g + t h a t + i t + i l l u s t r a t e d + t h e + n e e d + f o r + % 2 2 i m p r o v e m e n t % 2 2 + i n + m o s t + c o u n t r i e s t h e + r e p o r t + f o u n d + t h a t + a c c e s s + t o + r e n a l + c a r e + f o r + k i d n e y + d i s e a s e + p a t i e n t s + w a s + % 2 2 u n e q u a l % 2 2 + a n d + % 2 2 e r r a t i c % 2 2 + w i t h + o n e + i n + f i v e + p a t i e n t s + p o l l e d + s a y i n g + t h e y + h a d + n o t + r e c e i v e d + i n f o r m a t i o n + t h e y + f o u n d + u s e f u l + o n + d i a l y s i s + t r e a t m e n t + o p t i o n s o n e + i n + t h r e e + p a t i e n t s + s u r v e y e d + s a i d + t h e y + w e r e + n o t + a b l e + t o + c h o o s e + t h e i r + t r e a t m e n t + m e t h o d + o r + w e r e + u n s u r e + a b o u t + h o w + m u c h + t h e i r + c h o i c e + c o u n t e d % 2 c + w h i l e + l e s s + t h a n + h a l f + s a i d + t h e y + b e l i e v e d + t h a t + t h e y + w e r e + o n l y + t o l d + a b o u t + a l t e r n a t i v e + t r e a t m e n t + o p t i o n s + w h i l e + a l r e a d y + o n + d i a l y s i s t h e + k e y + c h a l l e n g e s + i d e n t i f i e d + b y + t h e + p o l l + w e r e % 2 c + s a i d + w i l h e l m s s o n % 2 c + % 2 2 e a r l y + d e t e c t i o n % 2 c + e q u a l + q u a l i t y % 2 c + a c c e s s % 2 c + i n f o r m a t i o n + a n d + t h e + e d u c a t i o n + o f + p a t i e n t s % 2 2 a n + e u + w i d e + t r e a t m e n t + r e g i s t e r f u r t h e r + c o m m e n t + c a m e + f r o m + m a r k + m u r p h y % 2 c + a l s o + a + v i c e + p r e s i d e n t + o f + c e a p i r % 2 c + w h o + c a l l e d + f o r + m o r e + e f f e c t i v e + m o n i t o r i n g + o f + t h e + t r e a t m e n t + a v a i l a b l e + t o + p a t i e n t s % 2 c + i n c l u d i n g + a + p o s s i b l e + m a n d a t o r y % 2 c + e u - w i d e + r e g i s t e r h e + s a i d % 2 c + % 2 2 t h e r e + a r e + s i g n i f i c a n t + d i f f e r e n c e s + i n + t h e + c o s t + o f + t r e a t m e n t + f o r + k i d n e y + p a t i e n t s + b e t w e e n + m e m b e r + s t a t e s + a n d + t h i s + i s + s o m e t h i n g + w e + w a n t + t o + s e e + a n + e n d + o f % 2 2 m u r p h y + a d d e d + t h a t + t h e + c h e a p e s t + t r e a t m e n t + w a s + t r a n s p l a n t a t i o n % 2 c + w h i c h + h e + s a i d + c o s t + a r o u n d + t h e + s a m e + a s + a + y e a r % 2 7 s + w o r t h + o f + d i a l y s i s + h o w e v e r % 2 c + t h e r e + a r e + a l s o + s i z e a b l e + d i f f e r e n c e s + i n + t h e + c o s t + o f + d i a l y s i s + t r e a t m e n t a r o u n d + 9 0 + p e r + c e n t + o f + d i a l y s i s + p a t i e n t s + u s e + h d % 2 c + w h i c h + i s + m a i n l y + p e r f o r m e d + i n + h o s p i t a l s + m u r p h y + s a i d + t h a t + s t u d i e s + h a v e + p r o v e n + t h a t + b e t w e e n + 3 5 - 5 5 + p e r + c e n t + w o u l d + p r e f e r + t o + b e + t r e a t e d + a t + h o m e + i f + g i v e n + t h e + c h o i c e % 2 2 e u + m e m b e r + s t a t e s + a r e + s p e n d i n g + a r o u n d + t w o + p e r + c e n t + o f + t h e i r + t o t a l + h e a l t h c a r e + b u d g e t + o n + d i a l y s i s + t r e a t m e n t % 2 c + y e t + d i a l y s i s + p a t i e n t s + m a k e + u p + o n l y + a r o u n d + 0 2 + p e r + c e n t + o f + t h e + p o p u l a t i o n + n a t i o n a l + g o v e r n m e n t s + m a y + n o t + b e + s p e n d i n g + t h e i r + b u d g e t s + w i s e l y % 2 2 % 2 2 h o m e + t r e a t m e n t + i s + c h e a p e r + a n d + p d + i s + s i g n i f i c a n t l y + c h e a p e r + b e c a u s e + i t % 2 7 s + d o n e + a t + h o m e + b y + p a t i e n t s % 2 2 m u r p h y + h i g h l i g h t e d + a + n u m b e r + o f + w h a t + h e + c a l l e d + % 2 2 b a r r i e r s + t o + o p t i m a l + c a r e + a n d + p a t i e n t + c h o i c e % 2 2 % 2 c + i n c l u d i n g + a f f o r d a b i l i t y % 2 c + a c c o u n t a b i l i t y % 2 c + h e a l t h + c a r e + p r o f e s s i o n a l + a n d + e d u c a t i o n % 2 c + c o m m e r c i a l + b i a s + g e o g r a p h i c a l + c o m p l e x i t i e s % 2 c + o r g a n + d o n a t i o n + c u l t u r e + a n d + t h e + s t r u c t u r a l + m a n a g e m e n t + o f + h e a l t h + s e r v i c e s o n + a c c o u n t a b i l i t y % 2 c + m u r p h y + c a l l e d + f o r + a n + e u + d i r e c t i v e + o n + m a n d a t o r y + r e p o r t i n g + t o + a + e u r o p e a n + r e n a l + r e g i s t r y + w h i c h + w o u l d + h e l p + s e t + e u r o p e - w i d e + s t a n d a r d s + o f + q u a l i t y + f o r + r e n a l + r e p l a c e m e n t + t h e r a p y + % 2 8 r r t % 2 9 h e + a r g u e d + t h a t + a + m a n d a t o r y + r e g i s t e r + a l r e a d y + e x i s t s + f o r + o r g a n + t r a n s f e r s + a c r o s s + t h e + e u % 2 c + b u t % 2 c + % 2 2 w e + n e e d + t o + k n o w + t h e + e u + 2 7 + n u m b e r s + o n + r r t + a + r e g i s t e r + h a s + t o + b e c o m e + m a n d a t o r y % 2 c + t h e r e + i s + a + r e a l + n e e d + f o r + g o o d + d a t a % 2 2 e d u c a t i o n + a n d + s u p p o r t m u r p h y + a l s o + c a l l e d + o n + t h e + e u + t o + t a k e + t h e + l e a d + i n + e d u c a t i n g + h e a l t h c a r e + p r o f e s s i o n a l s + i n + i d e n t i f y i n g + s y m p t o m s + a n d + s u p p o r t i n g + t h o s e + c o u n t r i e s + r e p o r t i n g + l o w + p r e v a l e n c e + o f + k i d n e y + d i s e a s e h e + a l s o + w a r n e d + a g a i n s t + w h a t + h e + c a l l e d + c o m m e r c i a l + b i a s + w i t h i n + t h e + p r e s c r i b i n g + o f + t r e a t m e n t s + l i n k e d + t o + s e r v i c e s + s u p p l y i n g + t h o s e + t r e a t m e n t s + f o r + p a t i e n t s % 2 c + s a y i n g % 2 c + % 2 2 w e + n e e d + t o + r e c o g n i s e + a n d + i n v e s t i g a t e + c o m m e r c i a l + i n t e r e s t s + % 5 b i n + t r e a t m e n t + c h o i c e s + f o r + k i d n e y + p a t i e n t s % 5 d + w e + d o n % 2 7 t + l e t + d o c t o r s + p r e s c r i b e + a n d + s e l l + m e d i c i n e s % 2 c + b u t + d o + l e t + d o c t o r s + p r e s c r i b e + d i a l y s i s + t r e a t m e n t + a n d + p r o f i t + f r o m + t h a t + t r e a t m e n t % 2 2 i r i s h + m e p + m a r i a n + h a r k i n + a l s o + w a r n e d + o f + t h e + d a n g e r s + o f + c o m m e r c i a l + b i a s % 2 c + s a y i n g + t h a t + t h e r e + w a s + a + n e e d + t o + e n s u r e + t h a t + t h e r e + w a s + n o + c o n f l i c t + o f + i n t e r e s t + s u r r o u n d i n g + t h e + r u n n i n g + o f + t r e a t m e n t + c l i n i c s s h e + s a i d + t h e r e + w a s + % 2 2 g r e a t + i n t e r e s t % 2 2 + i n + t h e + i s s u e + o f + p a t i e n t + c h o i c e + a n d + a c c e s s + t o + t r e a t m e n t + a n d + i n + % 2 2 w h a t + r o l e + % 5 b e u + p o l i c y m a k e r s % 5 d + c a n + p l a y % 2 2 + i n + i m p r o v i n g + p a t i e n t + a d v o c a c y s h e + a d d e d + t h a t + % 2 2 t h e r e + i s + a + n e e d + f o r + g o o d % 2 c + r o b u s t + i n f o r m a t i o n + a n d + p e r h a p s + w e + c a n + a d d + v a l u e + b y + l o o k i n g + i n t o + i s s u e s + s u c h + a s + w h e t h e r + t h e r e + i s + a + p o s s i b i l i t y + t o + a c c e s s + f u n d s + f o r + m o r e + r e s e a r c h + a t + e u r o p e a n + l e v e l + t h r o u g h + t h e + e u % 2 7 s + s e v e n t h + r e s e a r c h + f r a m e w o r k + p r o g r a m m e % 2 2 c l o s i n g + t h e + d e b a t e % 2 c + m u r p h y + s a i d % 2 c + % 2 2 w e + h a v e + c o m e + a + l o n g + w a y + o n + % 5 b p a t i e n t + c h o i c e s + a n d + a c c e s s + t o + t r e a t m e n t % 5 d % 2 c + b u t + t h e r e + i s + s t i l l + a + l o n g + w a y + t o + g o + % 2 2 t o d a y % 2 7 s + d i s c u s s i o n s + i n + t h e + e u r o p e a n + p a r l i a m e n t + m a r k + a + b i g + s t e p + t o w a r d s + e q u i p p i n g + p a t i e n t s + w i t h + i n f o r m a t i o n + a n d + s e c u r i n g + p a t i e n t + c h o i c e + a n d + e q u a l + a c c e s s + t o + r e n a l + c a r e % 2 c + b o t h + a t + e u r o p e a n + a n d + n a t i o n a l + l e v e l s % 2 2 f u r t h e r + r e a d i n g + h e r e % 0 a % 0 9 % 0 9 % 0 9 % 0 9 % 0 9 % 0 9 % 0 9 % 0 9 % 0 a % 0 9 % 0 9 % 0 9 % 0 9 % 0 9 % 0 9 % 0 9 % 0 9 % 0 a % 0 9 % 0 9 % 0 9 % 0 9 % 0 9 % 0 9 % 0 9 % 0 9)
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trailer
<<
/Size 33
/Root 32 0 R
/Info 31 0 R
>>
startxref
269882
%%EOF