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October 21, 2014

DaVita Kidney Care Welcomes Dr. John Wigneswaran

It is an honor to welcome Dr. John Wigneswaran to DaVita Kidney Care and the Office of the Chief Medical Officer (OCMO). John will be joining us as vice president of clinical affairs for the hospital services group. In this role he will lead the ongoing work that has made DaVita Hospital Services the best in the industry, including receiving the only accreditation for such services from The Joint Commission. In addition, John will be working closely with our clinical operations team to evaluate new technology, equipment and pharmaceuticals. Finally, he will be working as an integral member of OCMO, bringing his expertise to discussions of current and future clinical initiatives, as well as working closely with Dr. Bob Provenzano and the OCMO team on developing innovative programs to enhance physician engagement.

John is uniquely qualified to contribute substantially to these efforts at DaVita Kidney Care. In addition to holding an MD degree, he is completing his work toward an MBA at MIT. Further, he has founded Nephroceuticals, an organization focusing on the nutritional needs of kidney and cardiac patients. His broad range of interests, knowledge and accomplishments will make him an incredible resource to DaVita Kidney Care, its patients and its physicians. John is a remarkably committed individual who can blend clinical knowledge and skills with a warm, compassionate personality and complete alignment with our Mission and Values.

We are truly delighted to be able to welcome him to the Village!

You can follow John on Twitter at @doctorWIG.

July 30, 2014

Patient-Focused Quality Pyramid: FluidWise Edition

pouring water in a glass collection isolated

Every year, DaVita Kidney Care strives to improve clinical outcomes for our patients by evaluating the way nephrologists and dialysis caregivers approach patient care. Since 2000, we have succeeded in improving outcomes in specific areas relating to infection control, improved catheter rates, increased use of fistulas, better dialysis adequacy and year-over-year decreased mortality rates.[1] The end result of these improvements in care is increased overall quality of life for our patients. Read more…

July 9, 2014

DaVita Kidney Care Welcomes New Vice President of Clinical Affairs for Home Dialysis

DaVita Kidney Care’s mission is to be the Provider and Partner of Choice. To achieve this mission, we are continually recruiting top clinical leaders in nephrology research and clinical practice to join the DaVita Village. I am proud to announce that we have the honor of welcoming Martin Schreiber, M.D. to our physician leadership team as the vice president of clinical affairs for DaVita home dialysis and a member of the Office of the Chief Medical Officer. I have personally known Marty for more than 20 years and have seen how his commitment to clinical excellence has been a driving force throughout his nephrology career. He has devoted his life to improving the quality of care and quality of life for patients with chronic kidney disease, and is an internationally recognized clinician, researcher and advocate for home dialysis.

I am delighted to welcome Marty to the DaVita Village. My colleagues and I are excited to see such an exceptional physician have the opportunity to help lead the charge in delivering patient-centric care, enhancing patient choice and moving up the DaVita Patient-Focused Quality Pyramid.

July 2, 2014

Standing on the Shoulders of Giants: We Need More Giants in Nephrology

Standing on the shoulders of giants

In October 1978, after a year on the faculty at UCLA, I was invited to participate in a panel discussion on peritoneal dialysis (PD) at the Western Dialysis and Transplant Society’s (WDTS) Ninth Annual Meeting at the Hilton Hawaiian Village in Honolulu. During my training in nephrology at Northwestern University in Chicago (and my internship and residency at Michael Reese Hospital in that same city) I had become a strong advocate for PD. At that time I was placing Tenckhoff catheters at the bedside and prescribing either manual PD using bottled dialysate, or PD using the Baxter Physio-Control system, a proportioning device. I learned at the side of one of the great unsung leaders in dialysis therapy (then working at Lakeside VA Hospital), Dr. Peter Ivanovich—he had a deep passion for the care of patients but also understood the value in clinicians and clinical researchers collaborating with industry to guide research and development. Peter instilled in me many of the values that I have held throughout my career, and I remain grateful to him for that and am thrilled that he is still at it, now at Northwestern, helping drive innovation for kidney patients.

Read more…

June 27, 2014

DaVita Kidney Care Welcomes a World Class Leader in Saudi Arabia

In February I shared with many of you that DaVita Kidney Care was honored by the Ministry of Health in the Kingdom of Saudi Arabia with a contract to care for nearly half of the 10,000 dialysis patients currently under the ministry’s care. With this opportunity came a tremendous challenge, as the prevalence of chronic kidney disease (CKD) has accelerated faster in Saudi Arabia over the past three decades than in many parts of the world(1), and the need for strong healthcare providers, physicians and nurses has never been greater.

Today I am proud to welcome Dr. Abdulkareem Alsuwaida, FRCPC, MSc, to our physician leadership team as the chief medical officer (CMO) for DaVita in Saudi Arabia. I have known Abdulkareem for some time now and have seen how his commitment to clinical excellence has been a driving force throughout his nephrology career. He has devoted his life to improving the quality of care for patients with CKD, extending from their overall experience to their clinical outcomes.

Abdulkareem’s appointment to the CMO role adds to an already impressive career. He received his medical degree from King Abdulaziz University and his postgraduate medical education in internal medicine and nephrology from the University of Toronto. He has published more than 40 clinical research papers on dialysis, glomerulonephritis and lupus nephritis, and is a past president for the Saudi Society of Nephrology and Transplantation. While there, Abdulkareem led several CKD awareness initiatives and collaborated with key international groups dedicated to treating patients with CKD, including the International Society of Nephrology, the American Society of Diagnostic and Interventional Nephrology, the European Renal Association – European Dialysis and Transplant Association (ERA-EDTA) and the Screening and Early Prevention of Kidney Disease study group at Brigham and Women’s Hospital of Harvard Medical School.

Understanding the influence of research on improved outcomes, Abdulkareem has dedicated much of his career to uncovering new insights and has received accolades, including the 2006 Best Research Award from the Saudi Society of Nephrology and Transplantation, and the 2006 Best Research Award for King Fahad Medical City’s research day.

In addition to serving as DaVita’s CMO for Saudi Arabia, Abdulkareem is a professor of medicine and director of postgraduate education at King Saud University in Riyadh, as well as a consulting nephrologist in the division of nephrology at the King Khalid University Hospital.

Earlier this month, while attending the 51st ERA-EDTA Congress in Amsterdam, Abdulkareem shared with me that it was a top priority for both the Ministry of Health and the thousands of Saudi men and women affected by CKD that we provide the absolute highest quality of care. And he knew that joining DaVita was the path by which he could not only contribute to elevating the standard of care in the country, but also make a long-term commitment to improving the overall health of the population.

Please join me in welcoming Abdulkareem to the DaVita Village; my colleagues and I are excited to see such an exceptional physician have the opportunity to lead the charge in impacting patient care and quality of life on a larger scale in Saudi Arabia.



(1) Abdulla A. Al-Sayyari, FRCP,FACP, Faissal A. Shaheen, FRCP,FACP Saudi Med J 2011; Vol. 32 (4), http://smj.psmmc.med.sa/index.php/smj/article/viewFile/7158/4932

April 25, 2014

April is Donate Life Month


April is National Donate Life Month (NDLM), a time dedicated to encouraging Americans to register as organ, eye and tissue donors and to celebrating those who have given life by donating. As physicians, we see patients from across the kidney disease spectrum, from early stage to end stage kidney failure to transplant eligibility. Dialysis is an effective way of treating end stage renal disease, but most patients do not see it as their only long-term choice. The greatest gift we can give our patients is to encourage them to consider transplantation and to help them navigate the sometimes-turbulent waters of transplant evaluation.

Read more…

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.


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…

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