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Can an artificial kidney finally free patients from dialysis?

ucsf.edu

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Re: Can an artificial kidney finally free patients from dialysis?

#41

Post by DennisP »

brokenmeds wrote: post #38

Using throw-away as this sounds dismal, BUT: who makes money from this and who loses money? That will tell you whether this can happen or not. Dialysis is big business. Technicians. Consumables. Doctors. Repeated Vi$it$. Real estate (often owned by the Nephrologist $.) More saliently, Nephrologist also control the standard of care. Do they stand to gain more from artificial kidney surgery/maintenance, or do they stan…

On the other hand, the government spends a huge amount on dialysis. Medicare pays for it regardless of your age. Removing the need for dialysis simplifies life for politicians by putting off the day they need to raise taxes or cut Medicare services.

Dialysis is also a lot crappier than this would be. My mom was on dialysis and quality of life is not great. Neither is the expected lifespan.

Free markets have their flaws but their big advantage is competition. If the government approves this device, and it provides significantly better outcomes, then nephrologists who use it will take patients from those who don't.

Re: Can an artificial kidney finally free patients from dialysis?

#42

Post by DennisP »

piyushpr134 wrote: post #15

hope as much money & marketing is poured in cure, is also poured into prevention as it is better to prevent than to cure. I believe that many types of kidney diseases are linked to metabolic syndrome. Hope media and doctors highlight this to all and sundry that eating less, moving more, keeping weight and blood sugar in control can stop disease progression.

There's also polycystic kidney disease, which is a fairly common genetic condition.

Re: Can an artificial kidney finally free patients from dialysis?

#43

Post by DennisP »

hnbad wrote: post #30
porkbeer wrote: post #23

Earlier quoted context omitted.

I bet its cheaper than the alternative, expensive treatment for life...

Yes, and most people can't afford neither.

Medicare pays for dialysis, regardless of age. So it'll probably also pay for this, to save itself money.

Re: Can an artificial kidney finally free patients from dialysis?

#44

Post by DennisP »

esotericsean wrote: post #13

This probably isn't a viable solution for my father who has been on dialysis for 2 years and is in ESRD. I am a candidate for a kidney transplant for him (I went through the whole process), but he has other issues that have been preventing him from having another surgery. I'm pretty scared to do the procedure, too. But really glad to see progress being made here. Hopefully, also, the world works toward improving diet…

Also they say it'll be available by 2030 at the earliest: https://pharm.ucsf.edu/kidney/device/faq

Re: Can an artificial kidney finally free patients from dialysis?

#45

Post by zamadatix »

brokenmeds wrote: post #38

Using throw-away as this sounds dismal, BUT: who makes money from this and who loses money? That will tell you whether this can happen or not. Dialysis is big business. Technicians. Consumables. Doctors. Repeated Vi$it$. Real estate (often owned by the Nephrologist $.) More saliently, Nephrologist also control the standard of care. Do they stand to gain more from artificial kidney surgery/maintenance, or do they stan…

What does it matter who loses money? This isn't a 3 person scam, there are 10s of thousands of people capable and it only takes a single company getting a single practice in the area to start doing ${RADICALLY_MORE_EFFECTIVE_THING} and they get all of the pie while these stagnant people now get none. If there is some grand conspiracy of how they have enough power to prevent anybody from coming in and doing it better/cheaper to steal the larger volume then why do they need to protect this oddly specific set of jobs to get money? Basically, how does who from the past will lose expected income prevent someone who wants to become rich now?

Dialysis is indeed big business, but that means it's more attractive to upset - not less. The sad reality is it's just hard to upset. That's not as cool, it doesn't catch your attention, it doesn't give you anyone to blame for why things are shitty... but it's also a lot better supported as an explanation.

Re: Can an artificial kidney finally free patients from dialysis?

#46

Post by quasarj »

phibz wrote: post #4

As someone on dialysis, this would be amazing to see. I wonder if the same immunoresponse issues would happen with this like with a transplant. The holy grail of transplant medicine for years has been acquired immunity, where you convince the immunesystem not to attack the transplant. Still hoping we see progress there, but this looks like a viable alternative to a donor transplant.

Wish this was coming sooner. Maybe one day I'll have one!

Re: Can an artificial kidney finally free patients from dialysis?

#47

Post by tialaramex »

DennisP wrote: post #41
brokenmeds wrote: post #38

Using throw-away as this sounds dismal, BUT: who makes money from this and who loses money? That will tell you whether this can happen or not. Dialysis is big business. Technicians. Consumables. Doctors. Repeated Vi$it$. Real estate (often owned by the Nephrologist $.) More saliently, Nephrologist also control the standard of care. Do they stand to gain more from artificial kidney surgery/maintenance, or do they stan…

On the other hand, the government spends a huge amount on dialysis. Medicare pays for it regardless of your age. Removing the need for dialysis simplifies life for politicians by putting off the day they need to raise taxes or cut Medicare services. Dialysis is also a lot crappier than this would be. My mom was on dialysis and quality of life is not great. Neither is the expected lifespan. Free markets have their fla…

My understanding is that the firms who provide Medicare patient dialysis are very loathe to have patients exit their system, if they spend say $1000 on patient care and bill Medicare, the US government, for $1200 that's $200 of very safe profit. If that patient gets a transplant that's $200 of lost profits, regardless of how much healthier the patient is, and so they have no incentive to help patients get a transplant.

So for technologies, either xenotransplantation (GM pig kidneys) or artificial kidneys which eliminate dialysis, expect some push back from those firms, certainly expect them to have a more negative outlook on any safety studies etc. than you might expect if you think of them as neutral health professionals who are focused on patient outcomes.

Which of course doesn't magically mean these alternatives end up safer and healthier, they might turn out cheaper but worse, whereupon pushing to keep dialysis makes sense and you'd find yourself on the same side as the profiteers, but this happens, just like if you thought Prohibition was wrong and you found yourself alongside people whose businesses prey on problem drinkers...

Re: Can an artificial kidney finally free patients from dialysis?

#48

Post by standardUser »

brokenmeds wrote: post #38

Using throw-away as this sounds dismal, BUT: who makes money from this and who loses money? That will tell you whether this can happen or not. Dialysis is big business. Technicians. Consumables. Doctors. Repeated Vi$it$. Real estate (often owned by the Nephrologist $.) More saliently, Nephrologist also control the standard of care. Do they stand to gain more from artificial kidney surgery/maintenance, or do they stan…

Cynicism can be useful component of critical thought, but using it like a bludgeon and assuming it explains everything usually leads to conspiracy theories and wrong answers.

Re: Can an artificial kidney finally free patients from dialysis?

#49

Post by Gibbon1 »

DennisP wrote: post #41
brokenmeds wrote: post #38

Using throw-away as this sounds dismal, BUT: who makes money from this and who loses money? That will tell you whether this can happen or not. Dialysis is big business. Technicians. Consumables. Doctors. Repeated Vi$it$. Real estate (often owned by the Nephrologist $.) More saliently, Nephrologist also control the standard of care. Do they stand to gain more from artificial kidney surgery/maintenance, or do they stan…

On the other hand, the government spends a huge amount on dialysis. Medicare pays for it regardless of your age. Removing the need for dialysis simplifies life for politicians by putting off the day they need to raise taxes or cut Medicare services. Dialysis is also a lot crappier than this would be. My mom was on dialysis and quality of life is not great. Neither is the expected lifespan. Free markets have their fla…

Kidney failure is something the rich as well as the poor suffer from. A good comparison is a work friend had a heart valve replaced. That's way expensive, takes a top line cardiac team to do it safely. And big picture she's a nobody important. Yet they did it.

I think what the powers that be care about more than anything is the system exists to provide that kind of care as a routine thing. Which you won't have if you're just treating super wealthy people.

Re: Can an artificial kidney finally free patients from dialysis?

#50

Post by bobmaxup »

brokenmeds wrote: post #38

Using throw-away as this sounds dismal, BUT: who makes money from this and who loses money? That will tell you whether this can happen or not. Dialysis is big business. Technicians. Consumables. Doctors. Repeated Vi$it$. Real estate (often owned by the Nephrologist $.) More saliently, Nephrologist also control the standard of care. Do they stand to gain more from artificial kidney surgery/maintenance, or do they stan…

The world is a big place, and not everything is driven by commonsense demand and supply economics.
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