KCP Plans to Cut First-Year Dialysis Mortality by 20 Percent

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WASHINGTON—Every year a new U.S. Renal Data System report is released, the renal community is reminded of the persistent high-mortality rate for kidney disease patients in the first year of dialysis.

To combat this, Kidney Care Partners, a coalition of renal providers, patient advocates, professionals and manufacturers, announced a plan on June 3 to cut first-year mortality rates 20 percent by 2012.

If it’s successful, the “Performance Excellence and Accountability in Kidney Care,” or PEAK, campaign could save the lives of 10,000 dialysis patients, according to Kidney Care Partners.

“It’s a very serious campaign, not window dressing,” said Kent Thiry, who is the chairman of Kidney Care Partners, as well as the CEO of the dialysis provider DaVita. “We’re talking about real challenges. We’re talking about real accomplishments and investment.”

The first-year mortality rate for dialysis patients is approximately 30 percent, according to the 2008 USRDS report. In this area, the United States lags behind much of the developed world. According to a the Dialysis Outcomes and Practice Patterns Study, early mortality among patients starting dialysis in the United States was 33 percent higher compared to Europe and nearly three times higher than in Japan.

One explanation for the higher rate is that the United States cares for older and sicker patients. Also, reporting metrics may vary from country to country. However, “if you try to normalize for all those things, it still looks like some other countries do, in fact, do better,” Thiry said.

Thiry said other countries may be doing a better job in a number of areas, such as nutrition, how they handle time on dialysis, better primary and pre-ESRD care and vascular access. “These are some of the very issues that the coalition is very eager to investigate as we launch this campaign,” he said.

PEAK will focus on patient education and clinical care activities in order to reach its 2012 goal of reducing mortality by 20 percent.

For the campaign, Kidney Care Partners is working with research scientists from Brown University’s Gerontology Center, who will work with nephrologists to develop the project and track its progress. In addition, the campaign includes Rhode Island’s quality improvement organization, Quality Partners of Rhode Island, to help manage the project.

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