“This was an excellent symposium which reviewed problems that all dialysis units face: improving quality while at the same time addressing the total cost of care. The quality control tools discussed are shown to be effective and are easily applied in every treatment without extra costs”, as summarized by Bernard Canaud, Montpellier, France, the moderator of the Symposium.
The Chronic dialysis industry is faced with some tough challenges, especially considering that dialysis patient numbers continue to increase and the patient population is becoming older and more prone to sickness. It is becoming increasingly difficult to provide individualized and consistent dialysis. Even with the application of modern technology and medicine, patient outcomes are poor and quality of life is low. There is a clear demand for better quality-assurance methods are, to ensure less variability in care.
One important component for improving patient outcomes is dialysis-dose
The first presentation, given by Ingrid Ledebo, Gambro R&D, entitled “Managing both quality and cost with a growing dialysis population” focused on giving additional insights into these issues and into potential solutions to address today’s challenges in dialysis care. When Gambro in 2010 asked the dialysis community for their opinion on what could improve survival in dialysis, the response from more than 2300 nephrology professionals was that increased dialysis dose, time & frequency, improved treatment biocompatibility, and better hemodynamic stability during the treatment were all important. When asked for the single most important factor, most respondents stated the delivered dialysis dose. It is proposed that this relates to many practical difficulties in delivering the prescribed treatment at all times. This contributes to considerable variation over time in the amount of dialysis given. The need for quality control of each treatment was highlighted.
Dialysis is about delivering the prescribed dose and the required fluid removal at all times
The second presentation, entitled “Ionic dialysance—a tool to assure treatment adequacy and more” by Lucile Mercadal, Paris, France, focused on the value of Diascan®, an on-line clearance tool whereby it is possible to measure the effectiveness of dialysis and the delivered dose in every treatment. By using this tool the clinic can ensure that the prescribed dose is delivered to each patient, at every treatment session.
Dr. Mercadal explained how the technology, which is available in all Gambro’s contemporary machines for chronic dialysis, also allows to measure salt removal by dialysis and helps detect a poorly functioning vascular access.
The final presentation, “Blood volume control for probing of dry weight and achieving symptom-free treatments” by Antonio Santoro, Bologna, Italy, addressed how inadequate fluid removal by dialysis over time leads to high blood pressure, damage to the heart, and poor outcome. Fluid removal may also in many patients lead to symptomatic blood pressure drops during dialysis. The risk can be reduced by using a blood volume biofeedback control of the rate of fluid removal. This is referred to as Hemocontrol™, and the technique further helps to assess changes in the patient’s dry weight. The Hemocontrol™ system is an integrated feature of the Artis™ dialysis system.
Gambro is a global medical technology company and a leader in developing, manufacturing and supplying products and therapies for Kidney and Liver dialysis, Myeloma Kidney Therapy, and other extracorporeal therapies for Chronic and Acute patients. Gambro was founded in 1964 and has today 7 500 employees, production facilities in 9 countries, and sales in more than 100 countries.