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Funding for Dialysis / renal replacement therapy

Gertruida van Biljon, VictorOL Karusseit
BACKGROUND: The South African Renal Registry (SARR) was re-established in 2010. The first report was produced in 2014. It revealed that only 3182 patients out of 43.6 million people who were dependent on the state for medical care, received renal replacement therapy (RRT) in 2012 (73 per million population). METHODS: From the SARR report and 2012 dataset, a cross-sectional study was performed of children under 14 years of age who received chronic dialysis, and incident renal transplants in 2012...
October 15, 2016: Nephrology
Fergus J Caskey
Despite well-established, publicly-funded national health systems, kidney disease inequalities exist in Europe. There are differences between countries in rates of treated end-stage renal disease, at least some of which appears explained by organizational and economic factors. Pooling of chronic kidney disease (CKD) prevalence data is allowing new like-for-like comparisons between countries, which suggest that there are also differences in underlying rates of kidney disease. The few studies that exist suggest a paradoxically lower rate of earlier stages of kidney disease in ethnic minority groups, which have long been known to have higher rates of end-stage disease...
2016: Clinical Nephrology
Georgi Abraham, Madhusudan Vijayan, Rajalakshmi Ravi, Latha Kumaraswami, Malathy Venkatesan
Chronic kidney disease (CKD) is a major public health problem in India. The CKD registry of India has been formed to understand the epidemiology of CKD in India. Due to health economics in India, the majority of CKD-affected patients cannot afford renal replacement therapy (RRT) services. There is an unmet need to improve the awareness of kidney disease in India, and the focus should be on prevention and early detection of CKD by screening high risk populations. The Tamilnad Kidney Research (TANKER) Foundation is a charitable trust established in 1993 with the aim to improve awareness and provide quality affordable treatment to underprivileged patients...
2016: Clinical Nephrology
Anne-Line Couillerot-Peyrondet, Cléa Sambuc, Yoël Sainsaulieu, Cécile Couchoud, Isabelle Bongiovanni-Delarozière
OBJECTIVES: In the current pressured economic context, and to continue to treat the growing number of patients with high-quality standards, the first step is to have a better understanding of the costs related to end-stage renal disease (ESRD) treatment according to various renal replacement therapy, age, diabetes status, and clinical events. METHODS: In order to estimate the direct costs of all adult ESRD patients, according to (RRT) modality, patient condition, and clinical events, data from the French national health insurance funds were used...
May 5, 2016: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
Mariacristina Vecchio, Bibiana Bonerba, Suetonia C Palmer, Jonathan C Craig, Marinella Ruospo, Joshua A Samuels, Donald A Molony, Francesco Paolo Schena, Giovanni F M Strippoli
BACKGROUND: IgA nephropathy (IgAN) is the most common glomerulonephritis world-wide and a cause of end-stage kidney disease (ESKD) in 15% to 20% of patients within 10 years and in 30% to 40% of patients within 20 years from the onset of disease. This is an update of a review first published in 2003. OBJECTIVES: To determine the benefits and harms of immunosuppression for the treatment of IgAN. SEARCH METHODS: For this review update we searched the Specialised Register to 19 February 2015 through contact with the Trials Search Co-ordinator using search terms relevant to this review...
August 3, 2015: Cochrane Database of Systematic Reviews
Stephen P McDonald
The ANZDATA Registry includes all patients treated with renal replacement therapy (RRT) throughout Australia and New Zealand. Funding is predominantly from government sources, together with the non-government organization Kidney Health Australia. Registry operations are overseen by an Executive committee, and a Steering Committee with wide representation. Data is collected from renal units throughout Australia and New Zealand on a regular basis, and forwarded to the Registry. Areas covered include demographic details, primary renal disease, type of renal replacement therapy, process measures, and a variety of outcomes...
June 2015: Kidney International Supplements
Fergus J Caskey, Vianda S Stel, Robert F Elliott, Kitty J Jager, Adrian Covic, Ana Cusumano, Claudia Geue, Anneke Kramer, Benedicte Stengel, Alison M MacLeod
Rates of initiation of renal replacement therapy (RRT), use of home modalities of treatment and patient outcomes vary considerably between countries. This paper reports the methods and baseline characteristics of countries participating in the EVEREST study (n = 46), a global collaboration examining the association between medical and non-medical factors and RRT incidence, modality mix and survival. Numbers of incident and prevalent patients were collected for current (2003-05) and historic (1983-85, 1988-90, 1993-95 and 1998-2000) periods stratified, where available, by age, gender, treatment modality and cause of end stage renal disease (diabetic versus non-diabetic)...
February 2010: NDT Plus
Markus Riegersperger, Harald Herkner, Gere Sunder-Plassmann
BACKGROUND: Autosomal-dominant polycystic kidney disease (ADPKD) is a hereditary illness that causes renal tubular epithelial cells to form cysts that proliferate and destroy renal tissue. This usually leads to a decline in renal function, and often to terminal kidney failure, with need for renal replacement therapy. There is currently no causative therapy. The mammalian target of rapamycin (mTOR) inhibitor sirolimus (SIR) is an immunosuppressant with strong antiproliferative effects, and is potentially able to stop or reduce cyst growth and preserve renal function in ADPKD...
April 23, 2015: Trials
Mustafa Younis, Samer Jabr, Abdallah Al-Khatib, Dana Forgione, Michael Hartmann, Adnan Kisa
This study provides a cost analysis of kidney replacement therapy options in Palestine. It informs evidence-based resource allocation decisions for government-funded kidney disease services where transplant donors are limited, and some of the common modalities, i.e., peritoneal dialysis (PD) and home hemodialysis (HD), are not widely available due to shortages of qualified staff, specialists, and centers to follow the patient cases, provide training, make home visits, or provide educational programs for patients...
2015: Inquiry: a Journal of Medical Care Organization, Provision and Financing
Zaki Morad, Hui Lin Choong, Kriang Tungsanga, Suhardjono
The provision of renal replacement therapy (RRT) in developing economies is limited by lack of financial and other resources. There are no national reimbursement policies for RRT in many countries in Asia. The Southeast Asia countries of Singapore, Malaysia, Thailand, and Indonesia have adopted a strategy of encouraging public-private partnerships to increase the RRT rates in their respective countries. The private organizations include both for-profit and philanthropic bodies. The latter raise funds from ordinary citizens, corporations, and faith-based groups, as well as receive subsidies from the government to support RRT for patients in need...
May 2015: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Michelle C Lewicki, Kevan R Polkinghorne, Peter G Kerr
Since their inception in the 1960s, home-based dialysis therapies have been viable alternatives to conventional thrice weekly in center hemodialysis. In spite of this, uptake of these therapies has been steadily declining over past decades with utilization varying globally; dependent on training support, funding models, and prevailing Nephrologist beliefs. In the Australian context, home dialysis (predominantly peritoneal dialysis and extended hours nocturnal hemodialysis) is now again increasing in popularity--with enthusiasm driven not only by evidence of an array of physiological and psychological patient benefit but also significant economic advantage: critical in the current climate where dialysis therapies in Australia take approximately $1 billion dollars per year from the healthcare budget...
March 2015: Seminars in Dialysis
Odutola Israel Odetunde, Henrietta Uche Okafor, Samuel Nkachukwu Uwaezuoke, Bertilla Uzoma Ezeonwu, Oluchi Mildred Ukoha
A 5-year observational, retrospective study was conducted to evaluate the indications, the availability, the accessibility, the sustainability, and the outcome of children managed for acute kidney injury (AKI) and end stage kidney disease (ESKD) who required renal replacement therapy RRT in Enugu, southeast Nigeria. A total of 64 patients aged 5 months to 16 years required RRT, of which only 25 underwent RRT, giving an RRT accessibility rate of 39.1%. Eleven (44%) patients required chronic dialysis program/ renal transplant, of which only 1 (9...
2014: TheScientificWorldJournal
Mario Prieto-Velasco, Corinne Isnard Bagnis, Jessica Dean, Tony Goovaerts, Stefan Melander, Andrew Mooney, Eva-Lena Nilsson, Peter Rutherford, Carmen Trujillo, Roberto Zambon, Carlo Crepaldi
BACKGROUND: There is growing evidence that renal replacement therapy option education (RRTOE) can result in enhanced quality of life, improved clinical outcomes, and reduced health care costs. However, there is still no detailed guidance on the optimal way to run such programmes. To help address this knowledge gap, an expert meeting was held in March 2013 to formulate a position statement on optimal ways to run RRTOE. Experts were selected from units that had extensive experience in RRTOE or were performing research in this field...
2014: BMC Research Notes
Syed Adibul Hasan Rizvi, Syed Ali Anwar Naqvi, Mirza Naqi Zafar, Syed Fazal Akhtar
Pakistan is a low-resource country with a population of 185 million where expenditure on health is 1.3% of the gross national product. The estimated incidence of end-stage renal disease (ESRD) is 100 per million of the population. The paucity and high costs of renal replacement therapy render more than 90% of the ESRD population disenfranchised from replacement therapy. Our center, which is a government sector organization, established as an integrated dialysis and living related renal transplant program in the 1980s, where all services were provided free of cost to all patients with life-long follow-up care including medications...
May 2013: Kidney International Supplements
Mohamed Abdelraheem, El-Tigani Ali, Rania Osman, Rashid Ellidir, Amna Bushara, Rasha Hussein, Shiraz Elgailany, Yassir Bakhit, Mohamed Karrar, Alan Watson, Hasan Abu-Aisha
UNLABELLED:BACKGROUND: Acute Kidney Injury (AKI) is an important cause of morbidity and mortality in developing countries. Although continuous renal replacement therapy is gaining more popularity worldwide, peritoneal dialysis (PD) in children remains an appropriate therapy for AKI in children for all age groups including neonates. ♦ METHODOLOGY: We retrospectively reviewed all children who have been admitted with AKI at the pediatric nephrology unit, Soba University Hospital, Khartoum, during the period from January 2005 to December 2011...
July 2014: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Aditi Sinha, Arvind Bagga
Patients with end-stage renal disease require renal replacement therapy with maintenance hemodialysis or chronic peritoneal dialysis while awaiting transplantation. In addition to economic issues and limited state funding for advanced health care, the lack of trained medical personnel contributes to scarce dialysis facilities for children in developing countries. The establishment and operation of a hemodialysis unit with multidisciplinary facilities is both cost- and labor-intensive. Hemodialysis is usually carried out three times a week in a hospital setting and affects the curricular and extracurricular activities of the patient...
February 2015: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
S A H Rizvi, S Sultan, M N Zafar, S A A Naqvi, A A Lanewala, S Hashmi, T Aziz, A S Hassan, B Ali, R Mohsin, M Mubarak, S Farasat, S F Akhtar, A Hashmi, M Hussain, Z Hussain
The prevalence of pediatric RRT and transplantation are low in developing countries, 6-12 and <1 to 5 per million child population (pmcp), respectively. This is due to low GDP/capita of <$10 000, government expenditure on health of <2.6-9% of GDP and paucity of facilities. The reported incidence of pediatric CKD and ESRD is <1.0-8 and 3.4-35 pmcp, respectively. RRT and transplantation are offered mostly in private centers in cities where HD costs $20-100/session and transplants $10 000-20 000...
September 2013: American Journal of Transplantation
Anabela P Coelho, Helena O Sá, José A Diniz, Gilles Dussault
Portugal was the first European country to introduce an integrated management of end-stage renal disease (IM ESRD). This new program integrates various dialysis services and products, which are reimbursed at a fixed rate/patient/week called "comprehensive price payment." This initiative restructured the delivery of dialysis services, the monitoring of outcomes, and the funding of renal replacement therapy. This article described the implementation of a new model of comprehensive provision of hemodialysis (HD) services and aimed to assess its impact on dialysis care...
January 2014: Hemodialysis International
Antonio Carlos Cordeiro, Juan Jesús Carrero, Abdul Rashid Qureshi, Ricardo Ferreira da Cunha, Bengt Lindholm, Isac de Castro, Irene Lourdes Noronha
OBJECTIVES: Chronic kidney disease is a major public health problem worldwide. In Brazil, approximately 100,000 patients (January 2012) receive renal replacement therapy. Nevertheless, data on dialysis incidence in the Brazilian population are scarce. This study aims to analyze the incidence of patients starting dialysis therapy in São Paulo City, the largest Brazilian metropolis. METHOD: This cohort study analyzed data from 9,994 patients starting hemodialysis or peritoneal dialysis funded by the Brazilian Public Health System during a 5-year period (2007-2011)...
June 2013: Clinics
Martin J Andersen, Allon N Friedman
Nephrologists in the United States face a very uncertain economic future. The astronomical federal debt and unfunded liability burden of Medicare combined with the aging population will place unprecedented strain on the health care sector. To address these fundamental problems, it is conceivable that the federal government will ultimately institute rationing and other budget-cutting measures to rein in costs of ESRD care, which is generously funded relative to other chronic illnesses. Therefore, nephrologists should expect implementation of cost-cutting measures, such age-based rationing, mandated delayed dialysis and home therapies, compensated organ donation, and a shift in research priorities from the dialysis to the predialysis patient population...
July 2013: Clinical Journal of the American Society of Nephrology: CJASN
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