[Anthony]

Learn something new every day.

Interesting article.

http://www.aakp.org/aakp-library/Com...ates-Overseas/


After thinking about it for a while, somethiing occurred to me, certain statements in that essay:

"Europe Rations ESRD Treatment by Age, Gender and Co-Morbidity

Skewed selection and transplant rates are factors that make dialysis survival appear good on paper. International comparisons ignoring selection factors and attributing differences in survival to technique are meaningless. An inspection of the 1995 registry report of the European Dialysis and Transplant Association (EDTA) affirms the persistent exclusion of older uremic patients by stating, "The median age of ESRD patients in the UK in 1992 was 60 years, while in Sweden it was 66 years, in France 63 years and in Germany 62 years. Study of international registries reveals an economic influence on rationing limits for ESRD programs worldwide. Rationing is a kind term for restricting admission to dialysis.




In essence, other countries do not treat the elderly population who are in renal failure, and allow them to be "uremic". In other words, these people in renal failure are not treated with dialysis, are allowed to die from renal failure. Un-*uckin-believeable !

Clearly, treatment for ESRD patients is a product of governmental policies and economic pressures. Treatment of renal failure in the United Kingdom under performs countries in Western Europe and the United States. As recently as April 2000, Shaldon, a UK home hemodialysis pioneer, wrote, "Most distressing is the appalling state of dialysis availability in the United Kingdom. Although, successive governments since 1964 have refused to budget adequately for the needs of the renal services, the conspiracy of silence entered into by the medical profession seems to be equally responsible. As long as primary care doctors, acting as indoctrinated gatekeepers, refuse to refer elderly patients to renal units for dialysis, nephrologists can continue to claim that they accept all patients referred to them."

This means the primary care physicians are pre-screening the renal failure patients, to determine who are the best to be sent to the nephrologists for dialysis, and others who are not, and are "allowed" to die from renal failure. Again Un-*uckin-believable !

There is no doubt that outside the United States, many women, the elderly and racial minorities die untreated. In Eastern Europe, after the Berlin Wall fell, it became evident that ESRD therapy, though equivalent in survival to that reported for Western Europe, was restricted to Communist Party members or the otherwise rich and powerful. This means that a low ESRD treatment rate can hide deaths due to renal failure.


Did you read that first line?



The contrast between death rates in the United States and the truly spectacular outcome of dialysis units in France is repeatedly cited as evidence of American deficiency. Especially lauded is the unmatchable "landmark" longevity reported in Tassin, France. In 1983, Drs. Laurent, Calemard and Charra analyzed 373 hemodialysis patients. They found a remarkable survival rate of 75 percent at 10 years and 65 percent at 15 years. Although supposedly "an unselected population," there were actually only 15 patients (four percent) who had diabetes while another 15 (four percent) had systemic disease. What was the fate of uremic people in Tassin who were not accepted for dialysis (diabetic, very old, extensive systemic disease)? Obviously, they died, uncounted in any ESRD survival statistics. By providing dialysis to healthier patients, France and other European countries built a superior survival rate. American survival rates can never match this, as all American patients are accepted into our dialysis system.



Did you notice than in the US, ALL PEOPLE IN RENAL FAILURE ARE TREATED WITH DIALYSIS . NOT SO IN OTHER COUNTRIES, WHERE A FRACTION OF THE PEOPLE IN RENAL FAILURE ARE TREATED WITH DIALYSIS. THIS MEANS THE ONES NOT TREATED ARE ALLOWED TO DIE !!! UN-*UCKIN -BELIEVEABLE.