While this article is troubling in pointing out that patients may be receiving sub-optimal care, it does point out the need for improvement. There are far too many care practices that are simply not evidence-based.

Is 3 times a day dialysis more effective then every other day? What about every day? And, what about the cost implications.

This is similar to the debate regarding how often mammograms should be scheduled that was in the news last year.

For a great article related to evidence-based medicine, look here:

I will be 65 in November of this year and have been a dialysis patient for a little over two years and the article is very interesting to me for several reasons. Most of the patients I see at my clinic are older and much more sick than I am. They have many other issues other than ESRD but most of them still refuse to do the things they have to do to feel better. Diet and some limited exercise can make all the difference in the world. Not to mention how many people are allowed to have cups of iced drinks at their chair througout their treatment. DaVita just completed the purchase of the clinic I use in Canton,GA. Up to now most of the rules and regulations other than the state and federal mandated ones are all about money and what the former owners were willing to. In spite of the limited staff toward the end of the day with several patients still finishing treatments the staff at my clinic does a wonderful job. They are very over worked in my opinion but that's another thing all together. Finally, the comment from the DaVita person about dialysis not being fun, it can be! At least the experience of being with some great people is fun. It's like most things in life. You have to find the good in whatever you are involved with and laugh as much as possible. The staff and patients at my clinic are together more than we are with our own families and many of us have become like family. It's really a wonderful experience especially the part where you get to live longer by doing the right things! Having said all the positive things about dialysis the main negative would be an extra day a week treatment. I think the industry is more concerned with ways to get more money from the privately insured patients as possible and than would sure do it. My insurance company would probably be happy to pay only the $77,000 average mentioned in the article. It looks to me like they pay much more and that's a shame to have to put thsat high a price on staying alive!

"They don't even like coming in three times a week. It's completely understandable. It's not fun," said Dr. Allen Nissenson, chief medical officer at DaVita, which runs more than 1,600 clinics around the country."

Dialysis is not fun. In fact, it's a nightmare. My husband has been on it for over a year now. Why does the article not mention the option of home hemodialysis especially since DaVita provides this service???

Studies have proven that home hemo is much healthier and easier on the patient. More frequent but shorter treatment times.

Currently, my husband dialyzes four times a week. If anyone reading this is a dialysis patient or knows of one, please talk to your nephrologist or clinic about this. It has made a huge difference in the quality of life and health for my husband.

http://nxstage.com/