News Release

Kidney disease care -- what's in store for the future?

Anticipated dialysis clinic closures could compromise care; New initiative hopes to improve Americans' kidney health

Peer-Reviewed Publication

American Society of Nephrology

Highlights

  • Medicare will soon reduce reimbursements to some dialysis facilities, which may lead to closures. Patients will have to drive further to get care at other facilities, which could compromise their health.
  • The Healthy People initiative provides 10-year national objectives for improving the health of all Americans. Healthy People 2020 presents new kidney-related objectives.

Two studies presented during the American Society of Nephrology's Annual Kidney Week provide new information on kidney-related policies in the United States.

Beginning in 2011, Medicare has reduced reimbursements to some dialysis facilities, which could lead to closures. Mark Stephens (Prima Health Analytics) and his colleagues sought to estimate the incremental distances patients may need to travel in the event of reduced access to dialysis care. They found that, if 3% of facilities closed over the next three years, approximately 10,000 dialysis patients could be displaced, and the additional travel burden placed on these patients would accumulate to millions of additional miles traveled.

Patients living in rural areas would be most affected. "The average rural patient would have to travel more than 20 miles extra per treatment to access the next closest dialysis facility if their currently-used facility were to close," said Mr. Stephens.

Previous research has shown that patients who travel more than 15 minutes each way for dialysis treatments have lower quality of life and higher rates of death. Therefore, dialysis facility closures may adversely affect patients' health and quality of life.

In another policy presentation, Asel Ryskulova, MD, PhD (Centers for Disease Control and Prevention) offered a review of kidney-related objectives of the Healthy People initiative, which provides 10-year national objectives for improving the health of all Americans.

An estimated 11.5% of adults have evidence of chronic kidney disease (CKD), and each year in the United States, more than 100,000 people are diagnosed with kidney failure, the final stage of CKD. Reflecting the importance of CKD, 14 CKD objectives were included in the Healthy People 2010 national health goals. The Healthy People 2020 initiative was launched in December 2010, and it includes new kidney-related objectives that focus on monitoring and tracking:

  • Improvements in heart-related care in patients with CKD
  • Increases in the proportion of patients with CKD and diabetes who receive recommended exams and treatments
  • Reductions in the incidence and death rate of CKD
  • Increases in CKD awareness in people with poor kidney function

It's hoped that these new objectives will help reduce new cases of CKD and its progression, complications, disability, death, and economic costs.

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Study authors for "The End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) and Access to Care: Incremental Distance Traveled by Displaced Patients" (abstract SA-PO2640) include John Kochevar, PhD, Samuel Brotherton, Stephan Dunning, Larry Emerson, David Gilbertson, PhD, David Harrison, PhD, Ann McClellan, PhD, William McClellan, MD, John Mark Stephens, Shaowei Wan, PhD, and Matthew Gitlin, PharmD.

Study authors for "Determining National Priorities: Healthy People 2020 Chronic Kidney Objectives," (abstract TH-PO297) include Asel Ryskulova, MD, PhD, Lawrence Agodoa, MD, and Paul Eggers, PhD.

Disclosures available at http://www.asn-online.org/press/.

ASN Kidney Week 2011, the largest nephrology meeting of its kind, will provide a forum for 13,000 professionals to discuss the latest findings in renal research and engage in educational sessions related to advances in the care of patients with kidney and related disorders. Kidney Week 2011 will take place November 8 – November 13 at the Pennsylvania Convention Center in Philadelphia, PA.

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, and with more than 12,000 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.


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