End Stage Renal Disease

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The economics of end-stage renal disease Introduction According to the Centers for Disease Control and Prevention (CDC) 2010, 10% of adults in the United States have chronic kidney disease (CKD). That is estimated at about 20 million people. People with CKD may not feel any symptoms in the early stages, so treatment most likely has not been started. When a person often finds out they are in need of treatment, they may already be in kidney failure or end stage renal disease (ESRD). This paper will discuss the reimbursement mechanisms presented in the Sullivan article, the economics of providing ESRD treatment from the organization's point of view, patients options and potential trade-offs related to cost, quality, and access to…show more content…
Hemo dialysis is the filtration of blood to remove the toxins and it is done three times a week for three to four hours (Sullivan, 2010). This would require a person to have transportation to a dialysis clinic, and they would most likely not be able to hold a job. The second treatment option is peritoneal dialysis which consists of multiple exchanges of dialysate during the day which requires no equipment or by using a cycling machine at night (Sullivan, 2010). This can be done at persons home. If the cycling machine is used, a person is more likely to lead a normal life because the exchanges will be done at night when the person is sleeping. Both of these treatment options would require a surgery to obtain access to perform the dialysis. HD requires a vascular access. With vascular access there can become problems with infection and clotting (Sullivan, 2010). With PD a catheter is implanted into the lower abdomen. There is also the risk of infection and peritonitis with this treatment (Sullivan, 2010). PD may be more cost effective because the people on PD tend to be healthier and require less medications (Sullivan, 2013). The most ideal and cost effective treatment is transplantation (Sullivan, 2010). But even with transplantation there is the risk of rejection, so immunosuppressive medications must be taken for the duration of a person's life. According to the Organ procurement and transplantation network (2013), there are
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