ETOC

From the Field: Monthly Capitation Payment Breakdown

By Sarah Tolson In recent months, I’ve received an influx of questions from readers about the Medicare Monthly Capitation Payment (MCP). Many of these questions are related to the increasing utilization of physician assistants (PAs) and nurse practitioners (NPs), in addition to questions about CMS regulation changes at the beginning of the year that allow free-standing dialysis facilities and patient ... Read More »

HCV Status and Kidney Transplantation Outcomes

In the general population in the United States, the prevalence of hepatitis C virus (HCV) is ~1%; the prevalence among patients on hemodialysis ranges between 3% and 14%. Current US practice guidelines call for screening of all dialysis patients for HCV infection by testing for anti-HCV antibody and, more recently, HCV RNA to confirm chronic infection. For many patients with ... Read More »

Postdialysis Hypokalemia and All-cause Mortality in Patients on Hemodialysis

Among patients on hemodialysis, the mortality rate is 13.6 per 100 person-years, higher than in the general population. Sudden cardiac death is the leading cause of death in patients on hemodialysis, caused primarily by hyperkalemia, making serum potassium of particular interest in the management of dialysis patients. Serum potassium levels during dialysis are determined on the basis of the predialysis ... Read More »

From the Field: Tips for Successful Appeals

Sarah Tolson The word appeal is frequently considered a dirty word within the walls of Sceptre Management. Generally, by the time a payers’ requirements for appeal submission have been met, the claim in question is past due and the chances for obtaining full reimbursement have decreased. The entire appeal process is labor intensive, and success rates are generally not in ... Read More »

Scheduling Algorithm Improves Efficiency of Resources

Boston—At a large dialysis provider, nurses are assigned to have in-person assessment of patients identified as high risk for poor outcomes. The care coordination unit makes the assignments utilizing assessments made during the patient’s regularly scheduled dialysis treatments; the assessments serve as additional check-in on the patient’s health and well-being. Many hours of work each week are required to identify ... Read More »

Associations between Trans-fatty Acids and Survival in Renal Transplant Recipients

Trans-fatty acids (TFAs), unsaturated fatty acids, occur naturally in ruminant fats and dairy products; TFAs are produced by biohydrogenation in ruminant gut. However, according to Anupam Chandra, MD, and colleagues most TFAs in modern diets are found in industrial processed food, created by hydrogenating vegetable and fish oils. Margarines, crackers, and deep-fried foods contain partially hydrogenated TFAs due to properties ... Read More »

Transition versus Nontransition to Dialysis and Glycemic Status and Mortality

Because most previous trials of glycemic control excluded patients with advanced kidney disease, the optimal glycemic target in patients with chronic kidney disease (CKD) remains unclear. Earlier studies have shown microvascular and macrovascular benefits of intensive glycemic control in patients with both type 1 and type 2 diabetes with minimal to no kidney damage. However, more recent trials have shown ... Read More »

Cause of CKD among Agricultural Workers in Central America Unknown

During the past two or three decades, a large number of young workers in the sugarcane fields in Central America have been diagnosed with end-stage renal disease (ESRD). During the same time period (2002), researchers in El Salvador also reported an upsurge in chronic kidney disease (CKD). A key finding of the report was that the patients with CKD and/or ... Read More »

Access to Care for Hemodialysis Patients During Natural Disasters

Boston—Among patients dependent on renal replacement therapy, the effects of missed treatments are severe, making access to care for in-center hemodialysis patients critical during and after a natural disaster. Stephanie Baterseh (United Kingdom) and Vijay Lapsia, MD, (United States) conducted a review of existing literature to examine the state of the art in managing care of dialysis patients in the ... Read More »