Future of Dialysis????

Specialties Urology

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In lieu of the new health care reforms, Obama Care, what will the future hold for dialysis patients? Will dialysis nurses continue to have a job? I am on the verge of changing from ICU nurse to dialysis nurse and am worried about the future for the patients and myself. Any opinions?

merlee

1,246 Posts

I don't understand what your question is. Dialysis is not going to stop. And most patients on dialysis are on Medicare.

So, again, I ask you - - what is your question?

zero.

60 Posts

Specializes in Nephro-Dialysis / Intervention Radio.

I've been reading about future concepts in dialysis, and one of the ideas was to create and manufacture a dialyzer that may be permanently implanted on the patients body.

Quite an interesting idea, but to be real, it will still take decades for this to happen, and if and when it does, it will surely be too costly.

One good development at present though is the creation of kidneys through stem cells. Dialysis patients may soon have lesser waiting times for available kidneys since science can already create one for them using their own cells.

Chisca, RN

745 Posts

Specializes in Dialysis.

Name one politician that could survive an election promising to eliminate dialysis therapy.

Erikadawn RN

504 Posts

O.k so patients are going to stop needing or getting dialysis because "Obama Care" was signed ? Lol really?

anurseadvocate

216 Posts

Here is a link that probably shows (from CMS) that dialysis units will be here for a while -

CMS Rule Would Boost Payments to Dialysis Centers 3.1% in 2013

Press release from the Centers for Medicare & Medicaid Services. Summary

Now, my thinking is that this is a joke -- think about it! The new QIP reimbursement method used can deduct up to several percent reimbursement for not meeting certain measures/indicators, hence the 3.1% is basically a WASH ---

For you other part of question -- the """artificial wearable kidney""" if that is what you are speaking of - is still, as I understand, being worked on at one of the Universities in California and I think it might be UCLA but can't recall at this time -- it is still in the development stages - when it first was announced, a few years ago, I contacted the individual who was working on this -- you could probably do a google search to find out what and where it is now as far as process of development, however, think about it - this would take away alot of profit from the industry unless they were directly involved in this ....if more and more patients received this 'wearable artificial kidney'..... of course, they would still need to be monitored, etc... but with this Granuflo issue and the law suits that might occur as a result of such -- things might change drastically as some of us believe due to other major issues that have arisen over the last few years -..

nlovell

14 Posts

Specializes in Med/Surg, ECF, home care, Dialysis.

There is nothing Obama (or any other president) could do, no law he could sign, that would eliminate or even reduce dialysis in the foreseeable future. A "artificial wearable kidney" would be a major development for ESRD patients, for sure, but it's at the very least a decade (and I think I'm being generous) away from being available in mass quantities, for the majority of dialysis patients. And I pray that stem cell research does advance quickly enough to reduce the wait for transplants, but again it's not going to be available en masse any time soon. The bottom line is that hypertension and diabetes are the biggest contributors to kidney failure/dialysis and universal health insurance isn't going to impact that much. Most of the "new starts" i see didn't end up in the hospital because they didn't have access to health insurance. Diet, sedentary lifestyles and smoking are major factors in both diseases and until people (Americans especially) start taking control and improving their quality of life by simply taking better care of themselves, there will always be diabetes, always be hypertension, always be kidney failure...and always be a need for dialysis. No law, artificial kidney or stem cell is going to change that.

anurseadvocate

216 Posts

Yes, you are probably correct - and, keeping in mind, providers will try and prevent what they can if it cuts into their profits --

and, there are many patients who have led good lives e.g. eating right, minimal medical problems, good exercise programs, but for other reasons they needed dialysis,,, let's not forget that many of the dialysis patients did what they needed to do and did not neglect themselves --- we need to start looking at delivery of care in units - no one seems to be concerned with that -- yes, those here are conscientious staff who do care about patients, but believe me, there are units out there were patients experience substandard care and retaliation - big time

zero.

60 Posts

Specializes in Nephro-Dialysis / Intervention Radio.
There is nothing Obama (or any other president) could do, no law he could sign, that would eliminate or even reduce dialysis in the foreseeable future. A "artificial wearable kidney" would be a major development for ESRD patients, for sure, but it's at the very least a decade (and I think I'm being generous) away from being available in mass quantities, for the majority of dialysis patients. And I pray that stem cell research does advance quickly enough to reduce the wait for transplants, but again it's not going to be available en masse any time soon. The bottom line is that hypertension and diabetes are the biggest contributors to kidney failure/dialysis and universal health insurance isn't going to impact that much. Most of the "new starts" i see didn't end up in the hospital because they didn't have access to health insurance. Diet, sedentary lifestyles and smoking are major factors in both diseases and until people (Americans especially) start taking control and improving their quality of life by simply taking better care of themselves, there will always be diabetes, always be hypertension, always be kidney failure...and always be a need for dialysis. No law, artificial kidney or stem cell is going to change that.

Correct, it's not actually a question of whether dialysis will cease to exist in the future.

Remember that for CKD patients, they are presented with 3 options, DIALYSIS, KIDNEY TRANSPLANT, or DEATH.

And as long as diabetes and uncontrolled hypertension and other risk factors are there, CKD will also be there, and therefore dialysis too.

What will only change is the technology of how to deliver renal replacement therapy to these patients.

So going back to the thread starter, if you are looking for a change, yes you can try dialysis. You're knowledge and skills from your experience in ICU will be very useful.

anurseadvocate

216 Posts

Knowledge and skills from ICU can be, I agree, very valuable in a dialysis unit -- however, RNs working in dialysis will tell you it takes years to be experienced to be able to identify pending patient or machine problems, or actual problem solving with machines and patients -- being in charge of technicians who are not medical professionals, who receive education in a cookie - cutter fashion, often, not always, often take on responsibilities that nurses should -- I have watched in many units where the tech should have informed/contacted an RN to assess, but did not -- result - patient problems --- often techs feel if they go to the RN they will be viewed as not knowing what they are doing and their line of responsibility is not clear to them, often, at many units

McNurse532

3 Posts

Specializes in Level 1 Trauma ICU.

CIHI - Number of Canadians living with kidney failure triples over 20 years

Here is some information from Canada in regards to dialysis. Those canucks have been in the socialized realm for quite a while now, so this should answer your question.

McNurse532

3 Posts

Specializes in Level 1 Trauma ICU.

I think it is pretty clear what she is asking...

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