Renal Dialysis: Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION.Hemodialysis Units, Hospital: Hospital units in which care is provided the hemodialysis patient. This includes hemodialysis centers in hospitals.Capital Expenditures: Those funds disbursed for facilities and equipment, particularly those related to the delivery of health care.Dithioerythritol: A compound that, along with its isomer, Cleland's reagent (DITHIOTHREITOL), is used for the protection of sulfhydryl groups against oxidation to disulfides and for the reduction of disulfides to sulfhydryl groups.Kidney Failure, Chronic: The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION.Peritoneal Dialysis: Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure.Dialysis: A process of selective diffusion through a membrane. It is usually used to separate low-molecular-weight solutes which diffuse through the membrane from the colloidal and high-molecular-weight solutes which do not. (McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed)Dialysis Solutions: Solutions prepared for exchange across a semipermeable membrane of solutes below a molecular size determined by the cutoff threshold of the membrane material.Peritoneal Dialysis, Continuous Ambulatory: Portable peritoneal dialysis using the continuous (24 hours a day, 7 days a week) presence of peritoneal dialysis solution in the peritoneal cavity except for periods of drainage and instillation of fresh solution.Peritonitis: INFLAMMATION of the PERITONEUM lining the ABDOMINAL CAVITY as the result of infectious, autoimmune, or chemical processes. Primary peritonitis is due to infection of the PERITONEAL CAVITY via hematogenous or lymphatic spread and without intra-abdominal source. Secondary peritonitis arises from the ABDOMINAL CAVITY itself through RUPTURE or ABSCESS of intra-abdominal organs.Peritoneum: A membrane of squamous EPITHELIAL CELLS, the mesothelial cells, covered by apical MICROVILLI that allow rapid absorption of fluid and particles in the PERITONEAL CAVITY. The peritoneum is divided into parietal and visceral components. The parietal peritoneum covers the inside of the ABDOMINAL WALL. The visceral peritoneum covers the intraperitoneal organs. The double-layered peritoneum forms the MESENTERY that suspends these organs from the abdominal wall.Catheters, Indwelling: Catheters designed to be left within an organ or passage for an extended period of time.Hemodialysis Solutions: Solutions prepared for hemodialysis. The composition of the pre-dialysis solution may be varied in order to determine the effect of solvated metabolites on anoxia, malnutrition, acid-base balance, etc. Of principal interest are the effect of the choice of buffers (e.g., acetate or carbonate), the addition of cations (Na+, K+, Ca2+), and addition of carbohydrates (glucose).Ultrafiltration: The separation of particles from a suspension by passage through a filter with very fine pores. In ultrafiltration the separation is accomplished by convective transport; in DIALYSIS separation relies instead upon differential diffusion. Ultrafiltration occurs naturally and is a laboratory procedure. Artificial ultrafiltration of the blood is referred to as HEMOFILTRATION or HEMODIAFILTRATION (if combined with HEMODIALYSIS).Ontario: A province of Canada lying between the provinces of Manitoba and Quebec. Its capital is Toronto. It takes its name from Lake Ontario which is said to represent the Iroquois oniatariio, beautiful lake. (From Webster's New Geographical Dictionary, 1988, p892 & Room, Brewer's Dictionary of Names, 1992, p391)Urology: A surgical specialty concerned with the study, diagnosis, and treatment of diseases of the urinary tract in both sexes, and the genital tract in the male. Common urological problems include urinary obstruction, URINARY INCONTINENCE, infections, and UROGENITAL NEOPLASMS.Urology Department, Hospital: Hospital department responsible for the administration and provision of diagnostic and therapeutic services for the urologic patient.Nephrology: A subspecialty of internal medicine concerned with the anatomy, physiology, and pathology of the kidney.Health Facilities, Proprietary: Health care institutions operated by private groups or corporations for a profit.Newspapers: Publications printed and distributed daily, weekly, or at some other regular and usually short interval, containing news, articles of opinion (as editorials and letters), features, advertising, and announcements of current interest. (Webster's 3d ed)Dental Technicians: Individuals responsible for fabrication of dental appliances.Technology, Radiologic: The application of scientific knowledge or technology to the field of radiology. The applications center mostly around x-ray or radioisotopes for diagnostic and therapeutic purposes but the technological applications of any radiation or radiologic procedure is within the scope of radiologic technology.Career Choice: Selection of a type of occupation or profession.PropaneVascular Surgical Procedures: Operative procedures for the treatment of vascular disorders.Nephrotic Syndrome: A condition characterized by severe PROTEINURIA, greater than 3.5 g/day in an average adult. The substantial loss of protein in the urine results in complications such as HYPOPROTEINEMIA; generalized EDEMA; HYPERTENSION; and HYPERLIPIDEMIAS. Diseases associated with nephrotic syndrome generally cause chronic kidney dysfunction.Kidney Transplantation: The transference of a kidney from one human or animal to another.Water-Electrolyte Imbalance: Disturbances in the body's WATER-ELECTROLYTE BALANCE.Kidney Diseases: Pathological processes of the KIDNEY or its component tissues.Forecasting: The prediction or projection of the nature of future problems or existing conditions based upon the extrapolation or interpretation of existing scientific data or by the application of scientific methodology.Encephalitis Virus, Murray Valley: A species of FLAVIVIRUS, one of the Japanese encephalitis virus group (ENCEPHALITIS VIRUSES, JAPANESE), found in Australia and New Guinea. It causes a fulminating viremia resembling Japanese encephalitis (ENCEPHALITIS, JAPANESE).Encephalitis, Arbovirus: Infections of the brain caused by arthropod-borne viruses (i.e., arboviruses) primarily from the families TOGAVIRIDAE; FLAVIVIRIDAE; BUNYAVIRIDAE; REOVIRIDAE; and RHABDOVIRIDAE. Life cycles of these viruses are characterized by ZOONOSES, with birds and lower mammals serving as intermediate hosts. The virus is transmitted to humans by the bite of mosquitoes (CULICIDAE) or TICKS. Clinical manifestations include fever, headache, alterations of mentation, focal neurologic deficits, and COMA. (From Clin Microbiol Rev 1994 Jan;7(1):89-116; Walton, Brain's Diseases of the Nervous System, 10th ed, p321)Cellular Phone: Analog or digital communications device in which the user has a wireless connection from a telephone to a nearby transmitter. It is termed cellular because the service area is divided into multiple "cells." As the user moves from one cell area to another, the call is transferred to the local transmitter.GeorgiaGeorgia (Republic)Flavivirus: A genus of FLAVIVIRIDAE containing several subgroups and many species. Most are arboviruses transmitted by mosquitoes or ticks. The type species is YELLOW FEVER VIRUS.Salaries and Fringe Benefits: The remuneration paid or benefits granted to an employee.ChicagoMainstreaming (Education): Most frequently refers to the integration of a physically or mentally disabled child into the regular class of normal peers and provision of the appropriately determined educational program.Hemodialysis, Home: Long-term maintenance hemodialysis in the home.Parenteral Nutrition, Home: The at-home administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered via a route other than the alimentary canal (e.g., intravenously, subcutaneously).Water SofteningLiver Transplantation: The transference of a part of or an entire liver from one human or animal to another.Gilbert Disease: A benign familial disorder, transmitted as an autosomal dominant trait. It is characterized by low-grade chronic hyperbilirubinemia with considerable daily fluctuations of the bilirubin level.Medical Laboratory Science: The specialty related to the performance of techniques in clinical pathology such as those in hematology, microbiology, and other general clinical laboratory applications.Hyperbilirubinemia, Hereditary: Inborn errors of bilirubin metabolism resulting in excessive amounts of bilirubin in the circulating blood, either because of increased bilirubin production or because of delayed clearance of bilirubin from the blood.Technology, High-Cost: Advanced technology that is costly, requires highly skilled personnel, and is unique in its particular application. Includes innovative, specialized medical/surgical procedures as well as advanced diagnostic and therapeutic equipment.Laboratories, Dental: Facilities for the performance of services related to dental treatment but not done directly in the patient's mouth.British Columbia: A province of Canada on the Pacific coast. Its capital is Victoria. The name given in 1858 derives from the Columbia River which was named by the American captain Robert Gray for his ship Columbia which in turn was named for Columbus. (From Webster's New Geographical Dictionary, 1988, p178 & Room, Brewer's Dictionary of Names, 1992, p81-2)Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions.Equipment Failure: Failure of equipment to perform to standard. The failure may be due to defects or improper use.

Late referral of end-stage renal failure. (1/8259)

We studied all new patients accepted for renal replacement therapy (RRT) in one unit from 1/1/96 to 31/12/97 (n = 198), to establish time from nephrology referral to RRT, evidence of renal disease prior to referral and the adequacy of renal management prior to referral. Sixty four (32.3%, late referral group) required RRT within 12 weeks of referral. Fifty-nine (29.8%) had recognizable signs of chronic renal failure > 26 weeks prior to referral. Patients starting RRT soon after referral were hospitalized for significantly longer on starting RRT (RRT within 12 weeks of referral, median hospitalization 25.0 days (n = 64); RRT > 12 weeks after referral, median 9.7 days (n = 126), (p < 0.001)). Observed survival at 1 year was 68.3% overall, with 1-year survival of the late referral and early referral groups being 60.5% and 72.5%, respectively (p = NS). Hypertension was found in 159 patients (80.3%): 46 (28.9%) were started on antihypertensive medication following referral, while a further 28 (17.6%) were started on additional antihypertensives. Of the diabetic population (n = 78), only 26 (33.3%) were on an angiotensin-converting-enzyme inhibitor (ACEI) at referral. Many patients are referred late for dialysis despite early signs of renal failure, and the pre-referral management of many of the patients, as evidenced by the treatment of hypertension and use of ACEI in diabetics, is less than optimal.  (+info)

Impaired lysosomal processing of beta2-microglobulin by infiltrating macrophages in dialysis amyloidosis. (2/8259)

BACKGROUND: Macrophages may participate in amyloid fibril formation by processing the protein precursor. Although this theory seems to apply for amyloidosis, in which proteolytic cleavage is a prerequisite for amyloid fibril formation, it has not been demonstrated for beta2-microglobulin (beta2m) amyloidosis. We aimed to establish the role played by macrophages in beta2m amyloidosis. METHODS: We used a double immunogold electron microscopy technique, including mouse antihuman CD68, rabbit antihuman beta2m, amyloid P component, and lysosome-associated membrane protein (LAMP-1) antibodies. Differential density labeling studies of beta2m and amyloid P component were performed extra- and intracellularly to assess protein processing by macrophages. RESULTS: The cells surrounding amyloid fibrils were found to be mostly CD68 positive, suggesting that they were of monocyte-macrophage lineage. Intracellular accumulation of amyloid fibrils was also observed; these fibrils were constantly surrounded by LAMP-1-linked gold particles, demonstrating that intracellular beta2m was almost exclusively lysosomal. The rough-surface endoplasmic reticulum was not labeled by beta2m antibody, suggesting that there was no active synthesis of beta2m by the cells. As a marker of endocytosis, protruded cytoplasmic processes in close relation with the intracellular accumulations of beta2m amyloid fibrils were observed. No difference in density labeling (extracellular vs. intracellular) was observed for beta2m, whereas intracellular P component labeling was significantly decreased. CONCLUSIONS: All of these data are strongly suggestive of phagocytosis and not synthesis of amyloid fibrils by macrophages. Further, they demonstrate an impaired lysosomal processing specific for beta2m, as other compounds of the amyloid fibrils (P component) are significantly cleared.  (+info)

Septicemia in dialysis patients: incidence, risk factors, and prognosis. (3/8259)

BACKGROUND: Infection is second to cardiovascular disease as a cause of death in patients with end-stage renal disease (ESRD), and septicemia causes a majority of these infectious deaths. To identify patients at high risk and to characterize modifiable risk factors for septicemia, we examined the incidence, risk factors, and prognosis for septicemia in a large, representative group of U.S. dialysis patients. METHODS: We conducted a longitudinal cohort study of incident ESRD patients in the case-mix study of the U.S. Renal Data System with seven years of follow-up from hospitalization and death records. Poisson regression was used to examine independent risk factors for hospital-managed septicemia. Cox proportional hazards analysis was used to assess the independent effect of septicemia on all-cause mortality and on death from septicemia. Separate analyses were performed for patients on peritoneal dialysis (PD) and hemodialysis (HD). RESULTS: Over seven years of follow-up, 11.7% of 4005 HD patients and 9.4% of 913 PD patients had at least one episode of septicemia. Older age and diabetes were independent risk factors for septicemia in all patients. Among HD patients, low serum albumin, temporary vascular access, and dialyzer reuse were also associated with increased risk. Among PD patients, white race and having no health insurance at dialysis initiation were also risk factors. Patients with septicemia had twice the risk of death from any cause and a fivefold to ninefold increased risk of death from septicemia. CONCLUSIONS: Septicemia, which carries a marked increased risk of death, occurs frequently in patients on PD as well as HD. Early referral to a nephrologist, improving nutrition, and avoiding temporary vascular access may decrease the incidence of septicemia. Further study of how race, insurance status, and dialyzer reuse can contribute to the risk of septicemia among ESRD patients is indicated.  (+info)

Hemodialysis with high-calcium dialysate impairs cardiac relaxation. (4/8259)

BACKGROUND: During hemodialysis (HD), serum ionized calcium is directly related to the dialysate calcium concentration. We have recently shown an acute induction of hypercalcemia to impair left ventricular (LV) relaxation. In the current study we sought to establish whether changes in serum Ca++ also affect LV function during HD. METHODS: We echocardiographically examined the LV relaxation and systolic function of 12 patients with end-stage renal disease before and after three HD treatments with dialysate Ca++ concentrations of 1.25 mmol/liter (dCa++1.25), 1.5 mmol/liter (dCa++1.50), and 1.75 mmol/liter (dCa++1.75), respectively. Age- and sex-matched healthy controls were also examined echocardiographically. RESULTS: The LV posterior wall thickness and the interventricular septum thickness, and the LV end-diastolic dimension and the end-systolic dimensions were significantly greater in the patients when compared with the controls, and the LV fractional shortening, the ratio of peak early to peak late diastolic velocities (E/Amax), and the isovolumic relaxation time (IVRT) showed impairment of LV relaxation and systolic function in the patients. Serum ionized calcium increased significantly during the dCa++1.5 HD (1.24 +/- 0.10 vs. 1.34 +/- 0.06 mmol/liter, P = 0. 004) and dCa++1.75 HD (1.19 +/- 0.10 vs. 1.47 +/- 0.06 mmol/liter, P = 0.002), and plasma intact parathyroid hormone decreased significantly during the dCa++1.75 HD (medians 8.2 vs. 2.7 pmol/liter, P = 0.002). LV systolic function was not altered during any of the treatments. The changes in E/Amax and IVRT suggested impairment of relaxation during all sessions, but only during the dCa++1.75 HD was the impairment statistically significant (E/Amax 1. 153 +/- 0.437 vs. 0.943 +/- 0.352, P < 0.05; IVRT 147 +/- 29 vs. 175 +/- 50 msecond, P < 0.05). CONCLUSION: HD with high-calcium (dCa++1. 75 mmol/liter) dialysate impairs LV relaxation when compared with lower calcium dialysate (dCa++1.25 and dCa++1.5 mmol/liter) treatments.  (+info)

Activation of the kallikrein-kinin system in hemodialysis: role of membrane electronegativity, blood dilution, and pH. (5/8259)

BACKGROUND: The kallikrein-kinin system activation by contact with a negatively charged surface has been promulgated to be responsible for hypersensitivity reactions. However, to explain the low frequency and heterogeneity of hypersensitivity reactions, we hypothesized that not only the electronegativity of the membrane, but also other physicochemical parameters could influence the activation of the contact phase system of plasma assessed by the measurement of kallikrein activity and bradykinin concentration. METHODS: Plasma kallikrein activity using chromogenic substrate (S2302) and plasma bradykinin concentration (enzyme immuno assay) were measured during the perfusion of human plasma (2.5 ml/min) through minidialyzers mounted with six different membranes [polyacrylonitrile (PAN) from Asahi (PANDX) and from Hospal (AN69), polymethylmethacrylate (PMMA) from Toray, cellulose triacetate (CT) from Baxter, cuprophane (CUP) from Akzo and polysulfone (PS) from Fresenius]. RESULTS: A direct relationship was shown between the electronegativity of the membrane assessed by its zeta potential and the activation of plasma during the first five minutes of plasma circulation. With the AN69 membrane, the detection of a kallikrein activity in diluted plasma but not in undiluted samples confirmed the importance of a protease-antiprotease imbalance leading to bradykinin release during the first five minutes of dialysis. With PAN membranes, the use of citrated versus heparinized plasma and the use of various rinsing solutions clearly show a dramatic effect of pH on the kallikrein activity and the bradykinin concentration measured in plasma. Finally, increasing the zeta potential of the membrane leads to a significant increase of plasma kallikrein activity and bradykinin concentration. CONCLUSIONS: Our in vitro experimental approach evidences the importance of the control of these physicochemical factors to decrease the activation of the contact system.  (+info)

Practice patterns, case mix, Medicare payment policy, and dialysis facility costs. (6/8259)

OBJECTIVE: To evaluate the effects of case mix, practice patterns, features of the payment system, and facility characteristics on the cost of dialysis. DATA SOURCES/STUDY SETTING: The nationally representative sample of dialysis units in the 1991 U.S. Renal Data System's Case Mix Adequacy (CMA) Study. The CMA data were merged with data from Medicare Cost Reports, HCFA facility surveys, and HCFA's end-stage renal disease patient registry. STUDY DESIGN: We estimated a statistical cost function to examine the determinants of costs at the dialysis unit level. PRINCIPAL FINDINGS: The relationship between case mix and costs was generally weak. However, dialysis practices (type of dialysis membrane, membrane reuse policy, and treatment duration) did have a significant effect on costs. Further, facilities whose payment was constrained by HCFA's ceiling on the adjustment for area wage rates incurred higher costs than unconstrained facilities. The costs of hospital-based units were considerably higher than those of freestanding units. Among chain units, only members of one of the largest national chains exhibited significant cost savings relative to independent facilities. CONCLUSIONS: Little evidence showed that adjusting dialysis payment to account for differences in case mix across facilities would be necessary to ensure access to care for high-cost patients or to reimburse facilities equitably for their costs. However, current efforts to increase dose of dialysis may require higher payments. Longer treatments appear to be the most economical method of increasing the dose of dialysis. Switching to more expensive types of dialysis membranes was a more costly means of increasing dose and hence must be justified by benefits beyond those of higher dose. Reusing membranes saved money, but the savings were insufficient to offset the costs associated with using more expensive membranes. Most, but not all, of the higher costs observed in hospital-based units appear to reflect overhead cost allocation rather than a difference in real resources devoted to treatment. The economies experienced by the largest chains may provide an explanation for their recent growth in market share. The heterogeneity of results by chain size implies that characterizing units using a simple chain status indicator variable is inadequate. Cost differences by facility type and the effects of the ongoing growth of large chains are worthy of continued monitoring to inform both payment policy and antitrust enforcement.  (+info)

Ex vivo evaluation of a Taylor-Couette flow, immobilized heparinase I device for clinical application. (7/8259)

Efficient and safe heparin anticoagulation has remained a problem for continuous renal replacement therapies and intermittent hemodialysis for patients with acute renal failure. To make heparin therapy safer for the patient with acute renal failure at high risk of bleeding, we have proposed regional heparinization of the circuit via an immobilized heparinase I filter. This study tested a device based on Taylor-Couette flow and simultaneous separation/reaction for efficacy and safety of heparin removal in a sheep model. Heparinase I was immobilized onto agarose beads via cyanogen bromide activation. The device, referred to as a vortex flow plasmapheretic reactor, consisted of two concentric cylinders, a priming volume of 45 ml, a microporous membrane for plasma separation, and an outer compartment where the immobilized heparinase I was fluidized separately from the blood cells. Manual white cell and platelet counts, hematocrit, total protein, and fibrinogen assays were performed. Heparin levels were indirectly measured via whole-blood recalcification times (WBRTs). The vortex flow plasmapheretic reactor maintained significantly higher heparin levels in the extracorporeal circuit than in the sheep (device inlet WBRTs were 1. 5 times the device outlet WBRTs) with no hemolysis. The reactor treatment did not effect any physiologically significant changes in complete blood cell counts, platelets, and protein levels for up to 2 hr of operation. Furthermore, gross necropsy and histopathology did not show any significant abnormalities in the kidney, liver, heart, brain, and spleen.  (+info)

Hepatitis virus infection in haemodialysis patients from Moldavia. (8/8259)

BACKGROUND: Although the epidemiology of hepatitis B (HBV) and C (HCV) now seems well established for Western European countries, in Central and Eastern Europe < 50% of all dialysis centres routinely test for hepatitis C antibodies since testing is not available or is not applied to all patients. This study describes the prevalence, risk factors and clinical significance of HBV and HCV infection for the haemodialysis population of the North Eastern region of Romania, Moldavia. METHODS: The presence of HBV antigens was determined with an ELISA kit (Wellcome, Abbot) and HCV antibodies with the ELISA-3 Ortho-HCV, third generation test. The following individual data were collected: gender, age, duration of dialysis, rural/urban domicile, actual and previous HBV status, actual HCV status, known acute, clinically evident hepatitis episodes in the last 3 years, monthly alanine aminotransferase (ALAT) and aspartate aminotransferase (ASAT) levels, complete biochemical hepatic assessment at the time of the study, transfusions for the past 3 years and family history. RESULTS: HBV and HCV prevalences were 17% (stable over the last 3 years) and 75%, respectively; co-infection was seen in 10% of the subjects. Hospitalization (nosocomial infection) for HBV, blood transfusions and duration on dialysis for HCV, emerged as the main risk factors for hepatitis infection. Socio-economic conditions appear to be equally important for HCV infection, since the prevalence was significantly higher among patients from rural, underdeveloped areas than urban areas (80.8 vs 60.3%), and infection was already present in a large proportion of patients (47%) before starting dialysis, without being related to previous disease duration or blood transfusions. HBV and/or HCV was not associated with a worse clinical or biochemical profile at the time of the study. However, infected patients had significantly more previous cytolytic episodes, with higher, transient increases in ALAT and ASAT levels. CONCLUSIONS: HCV infection is endemic among dialysis centres in Moldavia. Apart from previously well-known risk factors for hepatitis infection, our study demonstrates the negative impact of socio-economic underdevelopment. Simple measures such as enforced general asepsia rules, careful disinfection and equipment sterilization, routine testing of patients from economically disadvantaged areas and monthly, serial determination of hepatic enzymes should be the common practice in dialysis centres in Romania.  (+info)

  • As an independent dialysis program, WRC is proud to be able to maintain its high standing among end-stage renal disease (ESRD) providers in the mid-Atlantic region. (wheelinghospital.org)
  • The suit alleges that RCG and RCGSC fraudulently billed for supplies and equipment provided to End Stage Renal Disease (ESRD) patients who received dialysis treatments at home. (justice.gov)
  • The government s complaint alleges that between January 1999 and December 2005, RCGSC submitted claims to Medicare for home dialysis supplies provided to ESRD patients for reimbursement of the supplies and equipment. (justice.gov)
  • Under federal law, the Medicare program pays companies that provide dialysis supplies to ESRD patients only if the companies that provide the supplies are truly independent from dialysis facilities and the ESRD patient chooses to receive supplies from the independent supply company. (justice.gov)
  • About 20 samples were collected from predialysis patients, 22 samples were collected from patients undergoing dialysis and 22 samples were collected from post dialysis patients. (scialert.net)
  • The samples were subjected to antioxidant enzyme analysis followed by flow cytometric and immunoflouroscence studies HO-1 expression was found to be elevated in all the dialysis conditions but higher elevation was observed in post dialysis patients. (scialert.net)
  • Blood pressure was measured at 15-minute intervals throughout the session and compared with post-dialysis symptom questionnaire results using mixed modeling to adjust for repeated measures in the same patient. (ox.ac.uk)
  • All of these claims, as well as related claims for support services rendered by RCG dialysis clinics are alleged to be false because the defendants were prohibited from billing, and not qualified to bill Medicare for these home dialysis patients. (justice.gov)
  • Ms. Williams was employed by RCG as a regional administrator and Dr. Martinez served as a medical director for RCG dialysis clinics in East Texas. (justice.gov)
  • This compilation offers its readers a great overview of the Renal Dialysis Equipment market during a forecast period from 2018 to 2025. (openpr.com)
  • For PY 2018, the addition of two new clinical measures, the standardized transfusion ratio and pediatric peritoneal dialysis adequacy, and three new reporting measures − pain assessment and follow-up, clinical depression screening and follow-up, and the National Healthcare Safety Network's healthcare personnel influenza vaccination measure. (lexology.com)
  • The global Renal Dialysis Equipment market will reach xxx Million USD in 2017 with CAGR xx% 2018-2023. (reportsnreports.com)
  • Europe and Asia Pacific has nearly similar market for renal dialysis but the growth rate of Asia Pacific renal dialysis market is higher. (sbwire.com)
  • An overview of the global market for renal dialysis equipment and accessories. (bccresearch.com)
  • This report focuses on the global market for renal dialysis and provides an updated review of market trends and applications in the dialysis industry. (bccresearch.com)
  • The report also covers the market for renal dialysis products by end user. (bccresearch.com)
  • Renal Outpatient Services is located on the second floor of the hospital. (lifebridgehealth.org)
  • ACHC has CMS deeming authority and provides accreditation for both In-Center Dialysis and Home Dialysis Support services, including new/initial certifications, renewal certifications, and service additions. (achc.org)
  • Additionally, ACHC offers temporary accreditation that allows renal dialysis facilities and service additions applying for initial certification to quickly offer services during the COVID-19 national public health emergency. (achc.org)
  • Other renal services in New Zealand are now requesting our input to facilitate their development," she said. (voxy.co.nz)
  • The great strides taken by the service - which includes renal services at the Waikato, Bay of Plenty, Lakes, Tairawhiti and Taranaki district health boards - have been spread across all levels, be they human, clinical or structural. (voxy.co.nz)
  • The proposed PPS provides a single bundled payment to dialysis facilities that would cover the items and services used in providing outpatient dialysis services, including dialysis treatment, prescription drugs and clinical laboratory tests. (lexology.com)
  • Under the proposed rule, CMS would establish a base bundled payment rate of $198.64 for all of the services related to a dialysis session, including the services in the current composite rate as well as items, including oral drugs, that are billed separately. (lexology.com)
  • Currently, Medicare pays for certain dialysis services under a partial bundled rate, known as the composite rate. (lexology.com)
  • The remainder of Medicare spending for dialysis services is for separately billed items such as drugs, but may also include laboratory services, supplies and blood products. (lexology.com)
  • Home Dialysis Tech - Home Dialysis Services. (juju.com)
  • Organizes and coordinates dialysis services provided and oversees operations. (salary.com)
  • Being a Renal Dialysis Director manages all inpatient and outpatient dialysis services. (salary.com)
  • VillageHealth members receive all care management and dialysis services from DaVita's team of specially trained professionals, including nephrologists, social workers, dieticians and pharmacists. (thestreet.com)
  • DaVita is the dialysis division of DaVita HealthCare Partners Inc., a Fortune 500® company that, through its operating divisions, provides a variety of healthcare services to patient populations throughout the United States and abroad. (thestreet.com)
  • Mayo supports a large chronic dialysis population with 450 patients at 15 units in Minnesota, Wisconsin, Iowa, and Florida (Mayo Clinic Dialysis Services). (mayo.edu)
  • Mail: Questions or completed Grievance Form, Consent to Disclose Your Identity and if appropriate a CMS Appointment of Representative Form to The Renal Network, 911 E. 86th Street, Suite 202, Indianapolis, IN 46240, Attention: Patient Services Department. (illinois.gov)
  • Following are the requirements and procedures through which your agency may be approved to be licensed as a provider of End Stage Renal Dialysis Center services. (wyo.gov)
  • You'll find renal (kidney) health services at Sacred Heart Hospital in Eau Claire and St. Joseph's Hospital in Chippewa Falls . (hshs.org)
  • Fresenius Medical Care is the world's leading provider of dialysis products and services. (freseniusmedicalcare.com)
  • As a recognized leader in Renal Dialysis accreditation, ACHC offers an educational survey approach with program-specific standards written with direct input from clinical staff and industry experts. (achc.org)
  • The prevalence and the clinical gravity of the various histopathological varieties of renal osteodystrophy in dialysis patients depends on the severity of both the aluminium intoxication and that of hyperparathyroidism. (unboundmedicine.com)
  • Formerly recognised as a service upon which national focus was required for improvement, Mr Smith is an example of why the Midland Regional Renal Service is increasingly being regarded as a national clinical leader in its field. (voxy.co.nz)
  • An Advanced Certificate can be obtained on successful completion of one year of study which includes theory, labtraining to operate dialysis machines and Clinical rotation to learn dialysis at a dialysis center or hospital. (ccc.edu)
  • The student will get the AAS degree on successful completion of two year of study which includes theory, lab training to operate a dialysis machines and Clinical rotation to learn dialysis at a dialysis center or hospital. (ccc.edu)
  • Last spring, Dr. Christoph Licht, Staff Nephrologist and Medical Director of the Dialysis and Apheresis Unit and his team performed the first clinical application of a modified continuous flow peritoneal dialysis (CFPD) at SickKids on baby Emily when she was just over a month old and under 2 kg. (sickkids.ca)
  • The results of those programs have been such that widespread clinical application of chronic dialysis has been advocated. (annals.org)
  • If you need renal dialysis, your care will be coordinated by one of our board certified nephrologists who, along with your own physician, monitors your need for medication, dietary changes and dialysis schedules. (saintjosephs.org)
  • Care is coordinated by board-certified Nephrologists, who work in conjunction with each patient's primary physician, to monitor medication, dietary changes and dialysis schedules. (saintjosephs.org)
  • Renal & Urology News publishes timely news coverage of scientific developments of interest to nephrologists and urologists, including in-depth coverage of all relevant medical conferences. (renalandurologynews.com)
  • RPA fully supports the FDA's mission to protect the nation's public health by assuring the safety, efficacy, and security of products such as PD solution, and we appreciate the attention that FDA devotes to safety issues affecting the care delivered to populations of patients such as those on dialysis,' the professional organization of nephrologists said in a letter to the FDA. (healio.com)
  • Nephrologists often face difficult decisions when recommending dialysis or non-dialysis (supportive) care for elderly patients, given the uncertainty around survival and the burden of dialysis. (nih.gov)
  • We conducted a DCE among Australasian nephrologists consisting of 12 scenarios of two patients (described in terms of age, gender, cognition, comorbidity, life expectancy, current quality of life (QOL), expected QOL with dialysis, social support, patient and family inclination). (nih.gov)
  • Nephrologists were willing to forgo 12 months of patient survival to avoid substantial QOL decrease with dialysis. (nih.gov)
  • Nephrologists avoided dialysis recommendation if it was expected to considerably reduce QOL. (nih.gov)
  • The high cost of dialysis treatment, especially in low- and middle-income countries where the majority of the population is unaware of such treatment restrains the growth of the market. (marketresearch.com)
  • The study highlights the exceptionally high cost of dialysis treatment. (who.int)
  • Several approaches can be suggested to decrease the rate of RRF loss in pediatric patients treated with chronic peritoneal dialysis: potentially nephrotoxic drugs (e.g., aminoglycosides), episodes of hypotension, and uncontrolled hypertension should be avoided, urinary tract infections should be treated promptly, and loop diuretics may be used to increase salt and water excretion. (hindawi.com)
  • Qyresearchreports include new market research report "2017-2022 Renal Dialysis Equipment Report on Global and United States Market, Status and Forecast, by Players, Types and Applications" to its huge collection of research reports. (openpr.com)
  • During the 3-month period, employees and patients in the dialysis center were considered contacts and evaluated. (cdc.gov)
  • The average Renal Dialysis Director salary in District of Columbia is $150,242 as of January 20, 2020, but the range typically falls between $126,311 and $174,602. (salary.com)