A New Approach to Kidney Care
Nearly 700,000 people in the U.S. are living with advanced kidney disease. According to a recent study, that number is expected to grow to more than one million by 2030 because of the increase in obesity and aging baby boomers. Hundreds of thousands of those with end-stage kidney disease have to spend several days a week attached to a dialysis machine just to survive.
Last month, President Donald Trump signed an executive order for what could be the biggest change in kidney care in decades. It would encourage the use of home dialysis (versus center-based), organ transplantation when appropriate, improve preventative care, increase education, and remove some of the provider payment obstacles currently in place in the Medicare system.
Nephrologists – those who care for people with kidney disease - say the change will not only save money, but also improve care for those most in need.
“Despite being just one percent of the Medicare population they consume 7% of the entire Medicare budget. So we're talking about people who are really sick or use a lot of our medical resources and we want to try to improve their care and lower the cost of that care and want to align everybody to be pushing towards that goal,” says Samer Sader, M.D.
Dr. Samer Sader is a nephrologist with Peoria, Illinois-based RenalCare Associates, part of the Illinois Kidney Disease & Hypertension Center. He says only 10% - 12% of people nationwide are doing home dialysis. In central Illinois, that number is closer to 18% because of the push by his team to encourage it.
He says people on home dialysis often do better with managing their disease and living a more normal life.
“Your kidneys work 24/7. When you go to a dialysis center we’re trying to do what your kidneys do all day long in three days for about 4 to 5 hours a day. When you do it at home, you get to do a little bit of dialysis each day so that it's not as stressful on the person. The reality is if a person or a family member or a friend learns to do dialysis with them that they are going to be more consistent over a longer period of time and ultimately do a better job.”
There are nearly 100,000 Americans waiting for a kidney transplant, and only about 20,000 get a transplant each year with thousands dying while waiting.
Dr. Sader says he and the nephrology community, in general, are excited about the push to change the focus of kidney care with an ultimate goal of reducing the number of people who develop end-stage renal disease.
“From our standpoint this is a big win. We want our transplant programs, our home dialysis programs to really be the main conduit to our patients. And we actually enjoy quite a bit the fact that they are really looking at delay of progression so that we don't even have to get to that discussion, and that would be the golden ticket for us is how do we avoid people getting to that point.”
The new plan also calls for the Department of Health and Human Services (HHS) to launch a public awareness campaign about chronic kidney disease, and to improve kidney disease tracking and detection nationwide.