Gambro Health Care Health Insurance Lead

The Path Not Taken on Dialysis | GoozNews

Anyone who thinks America has the best health care system in the world ought to take a look at its miserable record on caring for end stage renal disease patients on dialysis. About one of every five people who go on dialysis dies in the first year here, compared to less than one in seven in Europe and one in sixteen in Japan. Even after adjusting for age, gender, race and 25 co-morbid conditions (the primary causes of kidney failure are poorly treated diabetes and hypertension), the U.S. mortality rate is one-third higher than Europe and nearly four times the Japanese rate, according to a recent analysis . The average life expectancy of Americans on dialysis is about three years.

Taxpayers pay exorbitant sums for these poor outcomes. The Centers for Medicare and Medicaid Services, which cover treatment for end-stage renal disease, even for the non-elderly, spent $24 billion on dialysis in 2007. Just one percent of Medicare beneficiaries who are on dialysis generated a whopping 5.6 percent of the agency’s bills. Moreover, the obesity epidemic guarantees that those numbers will only shoot up in the years ahead since more than 100,000 people are now entering dialysis ever year – more than the number that die from the one of the conditions that leads to kidney failure.

You would think that the nephrology community would be up in arms over these alarming statistics, or at least looking for a less expensive and hopefully more effective way of caring for these predominantly poor patients. Yet two new studies in the Archives of Internal Medicine A small and declining number of patients receive peritoneal dialysis, an at-home alternative that generates comparable outcomes with greater patient satisfaction at 19 percent lower cost – $53,446 per year for patients on peritoneal dialysis versus $73,008 on in-clinic hemodialysis in 2007, according to one study .