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April 18, 2014

Online Tools for the Kidney Diet

This is a guest blog post by registered dietitian Sara Colman.

Knowing what to eat on a kidney diet can be complicated, and as kidney care providers we know how much support our patients need in planning meals and keeping up with nutritional goals. It’s important to provide an array of resources and tools to help patients achieve the highest quality of life possible.

For starters, patients can find education resources online. DaVita.com offers articles about kidney disease and dialysis treatments, as well as an entire section on the chronic kidney diet, including hundreds of kidney-friendly recipes.

Whether patients are pre-dialysis or currently on hemodialysis or peritoneal dialysis, they will find articles to help explain the kidney diet for their needs. Of course, there is no substitute for an in-person meeting with a renal dietitian.

Other kidney diet resources include the following:

Besides learning from educational articles, patients can use tools to help with meal planning and nutritional goals. For example, DaVita Diet Helper allows patients to plan meals, download suggested menus, create recipes, store a database of favorite foods and track daily food intake to see how it measures against goals for potassium, phosphorus, sodium and protein. The nutrition tracker and shopping list are available on mobile devices, too—perfect for patients on the go.

Even with the array of valuable tools, face-to-face consultations with patients about their diet are invaluable. It’s up to us as care providers to be the support team behind all our patients and their nutritional health. Help your patients stay on track with these resources and tools.

Sara Colman, R.D.N., C.D.E. blogs regularly at Kidney Diet Tips. Follow her on Twitter at @SaraColmanRD.

 

 

 

April 11, 2014

DaVita’s Patient-Focused Quality of Life Pyramid: Looking Beyond the Traditional Model of Care

The end stage renal disease program has a 40-year legacy of providing life-sustaining care to countless vulnerable patients with otherwise fatal kidney disease. There has been an intense focus on aspects of care delivered in the dialysis center, including anemia management, renal bone disease treatment, nutrition planning and the transition to vascular access. These critically important aspects of care must be provided at the highest level of quality.
Read more…

March 19, 2014

The Renal Physicians Association: Happy 40th Birthday!

Happy 40th, RPAWhen I was a young faculty member at UCLA, I had heard about the Renal Physicians Association (RPA) but did not think there would be any reason to join. After all, this was a group that focused on payment issues for nephrologists, and how could that possibly be relevant to someone who was a salaried doctor, and at an academic health center? As I delved into my responsibilities at UCLA, however, and became responsible for overseeing the care of patients in a large dialysis program almost entirely dependent on Medicare for reimbursement, it started to become clear to me how critical it was to have a strong advocacy organization that could work with Medicare and Congress to craft the most appropriate, effective and fair public policy for the end stage renal disease (ESRD) program. In addition, as clinical nephrology practice was becoming more complex with the new appreciation for the scope of the chronic kidney disease (CKD) epidemic, the need for tools to assist nephrologists in delivering the highest-quality care increased dramatically. I saw the light, and the rest is history. I joined RPA, worked on committees, served on the board of directors (1993-2006) and eventually served as president (1999-2001).

The nephrologists who originally formed RPA were ahead of their time. They began to build important relationships with the Health Care Financing Administration (HCFA), now called the Centers for Medicare and Medicaid Services. This collaboration served all nephrologists and kidney patients well in the subsequent four decades, with key regulatory and legislative achievements focused on improving the lives of patients while ensuring that nephrologists’ interest were represented as well. As the organization matured it began to focus intently on driving quality in ESRD care, and in 1993 it developed the first clinical practice guideline in our discipline—addressing adequacy of dialysis—several years before the Disease Outcomes Quality Initiative was begun. The most recent guideline on appropriate initiation and withdrawal of dialysis has become a seminal resource for nephrologists, patients and families to assist in decision-making at the difficult time of transition to dialysis. Myriad tools to assist nephrologists in optimizing care for CKD and ESRD patients have also been developed and disseminated.

I am particularly proud of RPA’s accomplishments during my two-year tenure as president. The following are some of the highlights:

  • RPA initiates Renal Fellows Workshop prior to annual meeting
  • First nephrology practice benchmarking survey conducted and presented
  • RPA launches corporate patrons program to engage in dialogue with industry supporters
  • RPA publishes first edition of the Renal Physicians Guide to Nephrology Practice
  • RPA convenes summit on chronic renal disease (with American Society of Pediatric Nephrology, American Society of Nephrology, and National Kidney Foundation)
  • HCFA responds to RPA’s request for community input on a method to measure and report on quality of renal dialysis services with establishment of the ESRD stakeholders council
  • RPA surveys randomly selected nephrology practices on expenses associated with the inpatient dialysis codes and the monthly capitation payment
  • RPA offers mortgage-financing assistance to members for home purchases
  • RPA publishes second clinical practice guideline on appropriate initiation and withdrawal of dialysis
  • RPA launches third guideline on appropriate patient preparation for renal replacement therapy
  • RPA publishes Capitation Models for ESRD: Methodology and Results—culmination of a two-year data-collection and -analysis effort supported by member contributions; risk-adjusted capitation rates and total spending for ESRD patient care
  • Past RPA president Dr. Derrick Latos becomes chair of the Practicing Physicians Advisory Council (established by Congress in 1990 to advise the Health and Human Services secretary on regulations and carrier manual instructions that relate to MD services under Medicare/Medicaid)
  • RPA launches patient safety initiative; convenes multistakeholder workshop
  • RPA launches website; creates www.renalmd.org
  • RPA testifies at Senate Special Committee on Aging in the ESRD program

I am very proud of what the organization accomplished during those years and subsequently, but now it’s time to focus on the future. The discipline of nephrology faces many challenges now and in the years to come: trainees’ waning interest in becoming nephrologists; continued downward pressure on reimbursement for nephrology procedures/activities; an increase in the number of employed physicians throughout healthcare; the rise of Accountable Care Organizations and other risk-taking, risk-sharing organizations; the increasing emphasis on value rather than volume in healthcare; federal budget constraints and pressure to restructure Medicare; a growing elderly, frail population with multiple chronic illnesses; etc., etc.

Some nephrologists are already throwing up their hands in despair, but my advice—which comes from years of watching the ESRD program grow and mature and from working with RPA—is to be a champion for our patients and our discipline. Helping strengthen RPA and being an active participant in the advocacy, public policy, and quality-of-care efforts is the best way to truly be a champion in nephrology.

As Muhammad Ali said,
Champions are made from something they have deep inside them—a desire, a dream, a vision.

HAPPY BIRTHDAY, RPA!

March 13, 2014

World Kidney Day Google+ Hangout On Air

Today is World Kidney Day, which is an important reminder of why kidney disease education and awareness are needed worldwide.

Roughly 1.4 million people across the globe are on dialysis and that number continues to grow each year. Kidney disease is a worldwide health concern. Today I participated in a Google+ Hangout On Air with Dr. Topoti Mukherjee, a nephrologist from India; Angela Lattimore, a dialysis patient from South Carolina; and Sara Hendren, a representative from the nonprofit program Bridge of Life – DaVita Medical Missions.

In case you missed it, here is the recording of the broadcast.

Read more…

March 11, 2014

Top 3 Easy Ways You Can Make an Impact During National Kidney Month

Once again, National Kidney Month is upon us. As nephrologists we deal with kidney disease on a daily basis, but the unfortunate reality is that chronic kidney disease (CKD) is a relatively unrecognized condition. Even though 1 out of 10 adults in the United States has kidney disease,[1] CKD has yet to reach the public awareness level of other chronic conditions, such as heart disease and diabetes. In fact, approximately 60 percent of patients with late-stage kidney disease are unaware their kidneys are failing.[2]

What does that mean for us as nephrologists? Our unique position as leaders in kidney care provides the opportunity to educate our patients, our loved ones and others in our communities. Here are three simple steps you can take to help raise awareness during National Kidney Month.

Read more…

February 26, 2014

5 things to look forward to at DaVita’s Physician Leadership Meeting

This year’s DaVita Physician Leadership Meeting (PLM) will be held Feb. 27 and 28 in San Diego, Calif. PLM is a gathering of DaVita medical directors and business leaders. This will be the ninth and largest PLM, with more than 1,000 attendees from 46 states across the country, including 700-plus medical directors.

Read more…

February 17, 2014

DaVita Honored to Treat Patients in Saudi Arabia

The recently announced partnership of DaVita and the Kingdom of Saudi Arabia is a great opportunity to work together with an outstanding healthcare-delivery system to improve the health of its citizens. Kidney disease is an emerging public health concern in Saudi Arabia, as it is in the United States. DaVita is honored to be able to bring our knowledge and experience to enhance what is already excellent care, as well as to continue learning how best to improve care for kidney patients. This is truly a winning situation for DaVita, for Saudi Arabia and for kidney patients.

Read on below for more details on this partnership.

Left to right: Vice Minister of Health and Health Affairs, Dr. Mansour Naser Al-Howasi, Charge d'Affaires, U.S. Embassy in Riyadh, Tim Lenderking, Minister of Health, Dr. Abdullah bin Abdul Aziz Al Rabeeah, Chief Operating Officer of DaVita HealthCare Partners, Dennis Kogod.

Left to right: Vice Minister of Health and Health Affairs, Dr. Mansour Naser Al-Howasi, Charge d’Affaires, U.S. Embassy in Riyadh, Tim Lenderking, Minister of Health, Dr. Abdullah bin Abdul Aziz Al Rabeeah, Chief Operating Officer of DaVita HealthCare Partners, Dennis Kogod.

Read more…

January 28, 2014

15 Million Americans Could Face Reduced Healthcare Options and Higher Costs

Fellow physicians,

I’m writing this post today to encourage you to join me and show your support in helping stop proposed Medicare Advantage cuts.

As early as February, Congress is expected to craft a longer-term solution for a Medicare payment system based more on quality and value than on the current fee-for-service system. Medicare Advantage (MA), one of the programs undergoing increased scrutiny, has allowed physicians to provide far better overall care to patients. Currently, almost 15 million seniors and people with disabilities rely on the care and benefits provided by MA plans. Over the next 10 years, Washington plans to cut $200 billion from these plans, which may lead to higher out-of-pocket costs, limited choice in physicians, fewer plans for managing chronic conditions and increased hospital readmission rates. While this cut does not directly affect dialysis patients, it has the potential to impact patients on a Medicare Advantage plan who are currently in earlier stages of chronic kidney disease.

 

“If implemented, the proposed funding cuts could affect millions of Americans.”

 

When we learn of legislative proposals that could affect vulnerable patients, we want to make sure that members of the physician community are aware of them and have the opportunity to voice concerns.

How can you help?

Tell Congress to stop cuts to MA. It takes only one minute to help protect patients across the nation.

  • Go to ProtectYourMA.com
  • Provide your zip code
  • Use the message template to contact your legislator

 

Show your support now >>

Thank you for your continued commitment to ensuring quality healthcare options for all.

 

Sincerely,

Allen R. Nissenson, MD, FACP
Chief Medical Officer

January 23, 2014

5 Twitter Accounts every Nephrologist should Follow

I’ve written before about Twitter accounts to follow for dialysis patient resources, and now I’d like to share a few accounts I think my fellow nephrologists will be interested in. With content ranging from tweets during recent events like ASN Kidney Week to links to articles and even nephrology humor, these accounts can’t be missed. The number of nephrologists and nephrology fellows on Twitter has certainly increased in the last few years and there are many great accounts to follow. In fact, I created a nephrologist list on Twitter where you can find more. Read more…

January 17, 2014

Kidney Care Trends That Will Shape 2014

It’s the beginning of a new year, and that means medical professionals are setting goals to further improve health outcomes for their patients. This is particularly important for patients who suffer from complex, chronic illnesses.

I’ve compiled a list of trends that I predict will play a large part in shaping kidney care during 2014, with a focus on patients with end stage renal disease (ESRD).

Working Instagraphic2Working patients. This was a hot topic closing out 2013 and will continue to gain attention throughout 2014. Admittedly, for some patients there are medical reasons that prevent them from  working when on dialysis; however, I foresee the kidney care community turning its focus toward the education of patients, employers and the public about the benefits of continuing to work despite being on dialysis. A key part of this educational effort will be an emphasis on treatment options for patients who can continue working. For such patients, the use of home dialysis modalities is particularly helpful. Read more…

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