title: A quality initiative. Reducing rates of hospitalizations by objectively monitoring volume removal.
abstract: Morbidity, hospitalizations, and costs for the treatment of individuals with end-stage renal disease are simply not improving at a rate that is acceptable to many physicians and dialysis providers in the United States. Various conferences and papers have suggested what processes need to become part of the dialysis prescription to accelerate change. Controlling cardiovascular disease is a part of that change, and controlling extra-cellular volume (ECV) is necessary to accomplish this. Three dialysis providers joined in a quality initiative to objectively assess the ultrafiltration process and measure "normalized" ECV, with the outcome objective to decrease ECV-related hospitalizations. The results show a decrease in ECV-related hospitalizations by 50%. The model of dialysis prescription needs to now change to Kt/V + objective ECV control.
authors.affiliation: Renal Ventures Management, Lakewood, Colo., USA.
authors.forename: Tom F
authors.initials: TF
authors.lastname: Parker
authors.forename: Raymond
authors.initials: R
authors.lastname: Hakim
authors.forename: Allen R
authors.initials: AR
authors.lastname: Nissenson
authors.forename: Mahesh
authors.initials: M
authors.lastname: Krishnan
authors.forename: T Christopher
authors.initials: TC
authors.lastname: Bond
authors.forename: Kevin
authors.initials: K
authors.lastname: Chan
authors.forename: Franklin W
authors.initials: FW
authors.lastname: Maddux
authors.forename: Richard
authors.initials: R
authors.lastname: Glassock
mesh_terms: D001810:Blood Volume; D019317:Evidence-Based Medicine; D005440:Fluid Therapy / Q000379:methods / Q000592:standards; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy*; D006435:Renal Dialysis / Q000379:methods* / Q000592:standards; D015996:Survival Rate