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The Cost Of Treating Kidney Disease

Medical spending to treat kidney disease totaled on average $25.3 billion annually from 2003 to 2007 (in 2007 dollars). Almost half of the expenditures ($12.7 billion) were spent on ambulatory visits.

On average, 3.7 million adults (1.7 percent of the population) annually reported getting treatment for kidney disease, reports a statistical brief from the Agency for Healthcare Research and Quality. During 2003-2007, for those ages 18 to 64, more than half of the total kidney disease expenditures were from ambulatory visits (53.1 percent) compared with about one third (30.3 percent) from inpatient visits. Among those age 65 and older, ambulatory visits accounted for 46 percent of the total kidney disease expenditures and hospital stays were 43 percent.

Similar amounts were spent on prescription medicines ($1.4 billion) and emergency room visits ($1.5 billion). Hospital stays amounted to $9.1 billion. Medicare paid 40 percent of the total expenditures to treat kidney disease.

*This blog post was originally published at ACP Internist*

A 16-Way Kidney Swap?

A team at Johns Hopkins has coordinated the world’s largest kidney swap, involving sixteen patients in multiple medical centers across the US. One of the donors was the vice president of human resources at Johns Hopkins Health System, a woman who has promoted organ donation and finally got a chance to do the ultimate charity work herself.

Johns Hopkins reports:

An altruistic donor started the domino effect. Altruistic donors are those willing to donate a kidney to any needy recipient. Just like falling dominoes, the altruistic donor kidney went to a recipient from one of the incompatible pairs, that recipient’s donor’s kidney went to a recipient from a second pair and so on. The last remaining kidney from the final incompatible pair went to a recipient who had been on the United Network for Organ Sharing (UNOS) waiting list.

As part of this complex procedure, Johns Hopkins flew one kidney to Henry Ford, one kidney to INTEGRIS Baptist and one kidney to Barnes-Jewish, In exchange, Henry Ford, INTEGRIS Baptists and Barnes Jewish each flew a kidney to Johns Hopkins.

The 16 surgeries were performed on four different dates, June 15, June 16, June 22 and July 6. The 10 surgeons in charge included four at Johns Hopkins, two at INTEGRIS Baptist, two at Barnes-Jewish and two at Henry Ford.

Johns Hopkins surgeons performed one of the first KPD transplants in the United States in 2001, the first triple-swap in 2003, the first double and triple domino transplant in 2005, the first five-way domino transplant in 2006 and the first six-way domino transplant in 2007. Johns Hopkins also performed the first multihospital, transcontinental three-way swap transplant in 2007 and the first multihospital, transcontinental six-way swap transplant in 2009.

Nearly 100 medical professionals took part in the transplants, including immunogeneticists, anesthesiologists, operating room nurses, nephrologists, transfusion medicine physicians, critical care doctors, nurse coordinators, technicians, social workers, psychologists, pharmacists, financial coordinators and administrative support people.

*This blog post was originally published at Medgadget*

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