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farmer too busy for daytime dialysis - Otago Daily Times

Johnny Bell is too busy to be sick.

The East Otago farmer might be living with chronic renal failure, but he just gets on with running Shag Valley Station while undergoing nocturnal dialysis every second night.

Personally determined and an inspiration to his family and friends, Mr Bell (48) has a philosophical approach to his condition, saying there were many others who were ''so much worse'' off.

''You've only got to be in a hospital ward for a day to see really bloody sick people . . . you don't want to go there,'' he said.

Mr Bell is fifth-generation on Shag Valley Station, a 4700ha sheep and beef property between Dunback and Green Valley.

It runs about 6000 ewes, 220 cows and some trading cattle and replacements.

Farming was not always his chosen occupation. After leaving school, he started training for a commercial pilot's licence but when his serious health issues were detected, plans changed.

He completed a degree in marketing and economics at Lincoln University before returning to Shag Valley to farm, following a kidney transplant donated by his mother Louise in 1989.

After 17 healthy years, the kidney failed in 2006, taking the family by surprise and he ''went down in a screaming heap'', his wife Tanya recalled.

Initially, Mr Bell was on dialysis during the day - not particularly helpful when trying to run a farm.

So Mr Bell chose nocturnal dialysis, spending every second night on dialysis for between eight and a-half and nine hours.

Support from his family, friends, neighbours and a farm worker enabled him to run the property.

''We could have easily sold up and lived happily ever after. [But] it's not just my farm, it's the children's as well and Tanya's,'' he said.

While Mr Bell acknowledged his wife was ''the rock'' - ''there's no doubt about that'' - Mrs Bell said it was made easier by her husband being so positive.

''I don't think you think you're sick. I don't think you think you've got a problem. You've just got chronic renal failure,'' she said with a smile.

''It was just another thing you had to factor into your day, without being flip about it. It was something you had to overcome.''

Mr Bell acknowledged it was ''not all beer and skittles'' being on dialysis and his hope was that technology in the future could mean the likes of a mechanical kidney for him.

''I do have that light at the end of the tunnel,'' he said.

In the meantime, while it would be ''relatively easy to sit there and be sorry for yourself'', that was not going to achieve anything.

''I don't have time to think about `I'm sick' or anything. I just get on with it,'' he said, in his matter-of-fact way.

The couple have three children, Lucy (17), Henry (15) and George (13) and the aim was to always ''keep things as normal as possible'' for them.

One difficulty was family holidays, but that was recently solved with the acquisition of a small caravan, which had been fitted-out to accommodate Mr Bell's fairly hefty dialysis equipment.

The family headed to Blenheim in January to watch George play in the South Island primary schools cricket tournament, in what Mrs Bell described as ''quite an adventure''.

While Mr Bell quipped the caravan was a ''fairly large umbilical cord'', which kept him alive, it allowed them greater freedom.

Being involved with his children's schools and activities was important, and he had coached rugby continuously for about 12 years, starting with Henry and before George left for boarding school this year.

While he was ''in a hiatus at the moment'', he would ''never say never'' about a return to coaching duties. He was also on the board of proprietors for John McGlashan College.

''In terms of doing pretty normal things, I do pretty normal things,'' he said.

This week is Kidney Health Awareness Week and today is World Kidney Day.

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PAHO/WHO and Latin American Society of Nephrology call for increased ... - SKNVibes.com

Odisha Samaya

PAHO/WHO and Latin American Society of Nephrology call for increased ...
SKNVibes.com
Washington, D.C., 10 March 2015 (PAHO/WHO) — The Pan American Health Organization/World Health Organization (PAHO/WHO) and the Latin American Society of Nephrology and Hypertension (SLANH) are calling for more efforts to prevent chronic ...
Diet high in red meat may make kidney disease worse NephrologyNews.com
Avoid unnecessary meds to keep kidneys healthy: Doctors Times of India
How the United States Stacks Up to Other Countries in Chronic Kidney Disease Huffington Post
WSAV-TV  - The New Indian Express  - pharmabiz.com
all 50 news articles »

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RPA annual meeting covers advocacy, business success, patient care delivery - NephrologyNews.com

The Renal Physicians Association (RPA) has planned its plenary sessions and workshops at its 2015 annual meeting to support its role as the recognized advocate for excellence in nephrology practice, representing and serving the interests of nephrology practitioners in their pursuit and delivery of quality renal health care.

In addition to the valuable updates provided on the latest developments affecting nephrology practice from the legislative, executive and administrative branches of government, speakers will address topics important to dialysis facility medical directors, opportunities for building strategic relationships to strengthen nephrology practices, and patient engagement opportunities to improve practice performance.

At the conference, Louise Aronson, MD, a geriatrics professor at UC Davis and author of the book, “A History of the Present Illness”, will present the Louis Diamond Lecture. Dr. Aronson uses story telling and narratives as an effective form of communication to engage patients in their care, and her talk entitled, “Improving Health Care One Patient at a Time” will challenge nephrology practitioners to rethink care delivery approaches.

Several sessions will focus on success factors for nephrology practices and how to prepare for participation in Medicare performance incentive programs such as the Physician Quality Reporting System  and Meaningful Use. Building relationships with primary care physicians, health systems and others will be critical to position practices for success in new value-based care models, such as accountable care organizations and others. Representatives from kidney care companies and health systems will share their perspectives on this topic. For those considering joint ventures, experts will address questions and concerns.


The Conference

Annual meeting

Renal Physicians Association

March 19-22 (includes pre-conference workshops)

Baltimore Hilton

To register and for program information, go to www.renalmd.org


At the individual nephrologist level, experts will share strategies for meeting the requirements for Maintenance of Certification and benchmarking for the value based payment modifier. With all of the additional regulatory requirements placed on practitioners in addition to their delivery of high quality kidney care, this meeting will address how to maintain the optimal work/life balance to avoid burnout and offer unique perspectives from female and young nephrologists.

The important and diverse roles of the dialysis facility medical director will also be addressed. What are the keys to effective leadership of the kidney care team? How can the medical director insure patient safety, manage difficult patients, and maximize patient engagement in their care? These questions will be answered to assist nephrologists with fulfilling their responsibilities as medical directors.

The last day of the meeting has a more clinical focus where speakers will review lessons learned from treating Ebola-related acute kidney injury, share what is new (and on the not-too-distant horizon) that may revolutionize vascular access care, and present the most important clinical trials and research that impacted nephrology patient care in 2014. The concluding session will provide attendees with the first results from a powerful, new data collaboration in ESRD patient care – the PEER Kidney Care Initiative.

The RPA annual meeting provides nephrologists and practice administrators an opportunity to exchange ideas for improving care delivery and patient outcomes, obtain solutions to practice challenges, and gain practical tools and resources to implement to enhance practice performance. It is critical for nephrology practitioners to attend to better understand the environmental changes affecting the specialty and learn how to succeed within the regulatory and legislative parameters.

 


Special pre-conference RPA workshops

For those who come one day early, the RPA is hosting three pre-Conference workshops.

  • A Maintenance of Certification Learning Session will provide participants with 10 points in ABIM’s Self-Evaluation of Medical Knowledge (Part II) requirement.
  • RPA is also holding its annual workshop for renal fellows. Transitioning from Training to Practice will equip fellows with knowledge about practice structure, employment models, contracts, coding and billing requirements – and other topics to prepare them to find the right practice situation in which to begin their career. This workshop is free for fellows and limited travel grants are available.
  • Fundamentals of Nephrology Coding and Billing will provide attendees with a full day of nephrology specific coding information geared to administrators, billing staff, and practitioners who must comply with complex coding questions on a daily basis.

The workshops will be held on March 19.

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Unusual CKD Identified in Salvadoran Women - Renal and Urology News
March 11, 2015

In a study, 6.6% of women had CKD that could not be attributed to diabetes, hypertension, or glomerulopathy.

Unusual CKD in Salvadoran Women
About a third of Salvadoran women studied had contact with agricultural chemicals.

Chronic Kidney Disease (CKD) mortality in El Salvador and Nicaragua is 4 times higher than anywhere else in the world. Studies have shown male agricultural workers, such as sugar cane harvesters, suffer and die from CKD at relatively early ages. Now a pioneering study of CKD in Salvadoran women further describes risk factors associated with the health crisis.

“Our research tends to support the hypothesis emerging from other studies, that the most plausible cause is a multifactorial one where an existing environmental and occupational nephrotoxic exposure is compounded by agrochemicals and heavy metal contamination which may constitute the trigger event,” stated Carlos M. Orantes Navarro, MD, of the Ministry of Health in San Salvador, and colleagues.

For the study, the investigators assessed CKD and its risk factors in 1,412 women from 1,306 families in 3 disadvantaged agricultural communities in El Salvador. Only 15% of the women were agricultural workers themselves.

According to results published online by Clinical Nephrology, CKD developed in 14% of women. About 9% had diabetes, 23% hypertension, 21% obesity, and 31% central obesity. Many women also had strong family histories of CKD, diabetes, and/or hypertension, ranging from 16 to 32%.

Remarkably, 6.6% of women had CKD as a result of non-traditional causes. “In our study, the low frequency of urinary renal damage markers may suggest the possibility of primary tubulointerstitial damage rather than primary glomerular damage,” according to the researchers.

About a third of women, for example, had contact with agricultural chemicals, including non-occupational exposure by inhalation, ingestion, or skin contact. Investigators identified 11 different chemicals, some pesticides, which are more prevalent in the region compared with other parts of the world. In addition, 84% of women took NSAIDs and 52% used medicinal plant products.

Future research may reveal and clarify the characteristics of CKD in this region, which too often proves a life-threatening problem.

Source
  1. Orantes Navarro, CM, et al. Published online by Clinical Nephrology; doi: 10.5414/CNP83S024.

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Fathima Health Foundation launches Mangaluru Dialysis Club - Daijiworld.com

Daijiworld.com

Fathima Health Foundation launches Mangaluru Dialysis Club
Daijiworld.com
Mangaluru, Mar 11: Fathima Health Foundation in collaboration with Indiana Hospital has launched Mangaluru Dialysis Club (MDC) for the benefit of patients suffering from renal failure. This was revealed at a press meet held here on Wednesday March 11.

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