Since 1972, many victims of endstage renal disease (ESRD) have received treatment under a unique Medicare entitlement. This book presents a comprehensive analysis of the federal ESRD program: who uses it, how well it functions, and what improvements are needed. The book includes recommendations on patient eligibility, reimbursement, quality assessment, medical ethics, and research needs. Kidney Failure and the Federal Government offers a wealth of information on these and other topics: The ESRD patient population. Dialysis and transplantation providers. Issues of patient access and availability of treatment. Ethical issues related to treatment initiation and termination. Payment policies and their relationship to quality of care. This book will have a major impact on the future of the ESRD program and will be of interest to health policymakers, nephrologists and other individual providers, treatment site administrators, and researchers.

“Inspiring and deeply distressing.” —Ezekiel J. Emanuel, author of Which Country Has the World’s Best Health Care? How did a lifesaving medical breakthrough become a for-profit enterprise that threatens many of the people it’s meant to save? Six decades ago, visionary doctors achieved the impossible: the humble kidney, acknowledged since ancient times to be as essential to life as the heart, became the first human organ to be successfully replaced with a machine. Yet huge dialysis corporations, ambitious doctor-entrepreneurs and Beltway lobbyists soon turned this medical miracle into an early experiment in for-profit medicine—and one of the nation’s worst healthcare catastrophes. With powerful insight and on-the-ground reporting, New York Times best-selling author Tom Mueller introduces an unforgettable cast of characters. Heroic patients, including a Hollywood stuntman and body double, risk their lives to blow the whistle on how they’ve been mistreated. An unpaid activist living in a south Georgia trailer park fights to save patients from involuntary discharge from their lifesaving care. Industry insiders put their careers on the line to speak out about the endemic wrongs and pervasive inequality they’ve witnessed—and about dialysis executives who dress as musketeers and Star Wars characters to exhort their employees to more aggressive profit-seeking. Mueller evokes the scientific ingenuity and optimism of the 1950s and 1960s, when the burgeoning field of organ transplant and early dialysis machines offered long-awaited hope for lifesaving care. That is, until a New York salesman had himself dialyzed on the floor of the House, and Congress made renal disease the only “Medicare for All” condition—opening the financial floodgates for Big Dialysis. Of the thousands caught in a web of corporate greed, a disproportionate number are Black and Latino, highlighting the stark racial divides already endemic to American medicine. How to Make a Killing reveals dialysis as a microcosm of American medicine and poses a vital challenge: find a way to fix dialysis, and we’ll have a fighting chance of fixing our country’s dysfunctional healthcare system as a whole, restoring patients, not profits, as its true purpose.

Overcome the toughest clinical challenges in nephrology with Brenner & Rector’s The Kidney -- the most well-known nephrology resource in the world. A diverse team of more than 200 international contributors brings you the latest knowledge and best practices on every front in nephrology worldwide. From basic science and pathophysiology to clinical best practices, Brenner & Rector’s The Kidney is your go-to resource for any stage of your career. Review of the basic science that underpins clinical nephrology, comprehensive selection of the most important bibliographical sources in nephrology, and Board Review-style questions help you prepare for certification or recertification. Coverage of kidney health and disease from pre-conception through fetal and infant health, childhood, adulthood, and into old age. Expanded sections and chapter on global perspective and ethical considerations. Uniform terminology and nomenclature in line with emerging consensus in world kidney community. More than 700 full-color high-quality photographs as well as carefully chosen figures, algorithms, and tables to illustrate essential concepts, nuances of clinical presentation and technique, and decision making provide a visual grasp and better understanding of critical information. Internationally diverse, trusted guidance and perspectives from a team of well-respected global contributors . An editorial team headed by Dr. Skorecki and handpicked by Dr. Brenner ensures the ongoing adherence to previous standards of excellence. All chapters have been extensively updated or entirely rewritten by authorities in their respective fields. The latest clinical information including recent clinical trials, genetic causes of kidney disease, cardiovascular and renal risk prediction in chronic kidney disease, new paradigms in fluid and electrolyte management, and pediatric kidney disease, keep you current with the rapid development of care and research worldwide.

With the increased prevalence of kidney transplantation, transplant recipients are being treated in a variety of clinical settings – often beyond the transplant center. There is a greater need for clinicians and allied healthcare professionals to have appropriate guidance on managing these patients. Kidney Transplantation offers the latest evidence-based information on the full range of dilemmas in the medical management of kidney transplant recipients before, during and after transplantation. Beginning with the selection of patients who are candidates for transplantation, this authoritative guide covers the care of the patient on the waiting list and evaluation of donors, preoperative care, induction and immunosuppression maintenance. This wealth of new information and guidelines will serve as an important resource for the best possible care for transplant patients.

Notions of justice and fairness are central to the American belief that the pursuit of a healthy and productive life is the right of all citizens. Yet in the real world there are seldom sufficient resources to meet the needs of everyone, and institutions are routinely forced to make difficult decisions regarding who will be favored and who will not. Local Justice in America is an insightful look into how selections are made in four critical areas: college admissions, kidney transplants, employee layoffs, and legalized immigration. This volume's case studies survey the history and modern rationale behind seemingly enigmatic allocation systems, chronicling the political and ethical debates, occasional scandals, and judicial battles that have shaped them. Though these selection processes differ significantly, each reflects a bitter struggle between opposing—and equally intense—principles of local justice. For example, are admissions officers who use special points to foster student diversity less fair than those who rely exclusively on scholastic achievement? How did the system of personal discretion among doctors selecting transplant patients come to be viewed by the public as more inequitable than compassionate? Does the use of seniority as a gauge in layoffs violate equal opportunity laws or provide employers with their only objective and neutral criterion? How have partisan interest groups repeatedly shifted immigration quotas between the extremes of xenophobia and altruism? In framing chapters, editor Jon Elster draws upon these studies to speculate on the unique nature of the American value system. Arguing that race matters deeply in all considerations of local justice, he discusses how our society's assessment of neediness balances on the often uneasy compromises between the desire to reward deserving individuals and the call to strengthen opportunities for disadvantaged groups. Well informed and stimulating, Local Justice in America speaks directly to policy debates in the fields of health, education, work, and immigration, and makes an important contribution to our understanding of the fundamental social issues that affect our daily welfare.

Palliative care has become increasingly important across the spectrum of healthcare, and with it, the need for education and training of a broad range of medical practitioners not previously associated with this field of care. As part of the Integrating Palliative Care series, this volume on palliative care in nephrology guides readers through the core palliative knowledge and skills needed to deliver high value, high quality care for seriously ill patients with chronic and end-stage kidney disease. Chapters are written by a team of international leaders in kidney palliative care and are organized into sections exploring unmet supportive care needs, palliative care capacity, patient-centered care, enhanced support at the end of life, and more. Chapter topics are based on the Coalition for Supportive Care of Kidney Patients Pathways Project change package of 14 evidence-based best practices to improve the delivery of palliative care to patients with kidney disease. An overview of the future of palliative care nephrology with attention to needed policy changes rounds out the text. Palliative Care in Nephrology is an ideal resource for nephrologists, nurses, nurse practitioners, physician assistants, social workers, primary care clinicians, and other practitioners who wish to learn more about integrating individualized, patient-centered palliative care into treatment of their patients with kidney disease.