The dialysis industry is growing at a significant rate due to increasing in the prevalence of organ failure, growing awareness in the field, and rise in the adoption rate of dialysis. The dialysis industry encompasses various other industries, including medical devices and health care services. Medical devices include dialysis products and supplies, whereas health care services include dialysis services, which require skilled professionals to execute the process successfully. Kidney dialysis equipment refers to the medical devices that are used for eliminating wastes and unwanted water from the blood. They are used in case of patients with failed or damaged kidney. Various causes of kidney failure include diabetes, hypertension, malaria, glomerulonephritis, polycystic kidney disease, long-term exposure to lead, solvents and fuels, jaundice, over-consumption of some medications, yellow fever, and others. On the basis of types, kidney dialysis equipment may be classified into hemodialysis and peritoneal dialysis. Two main principles of peritoneal dialysis are Continuous Ambulatory Peritoneal Dialysis (CAPD) and Continuous Cyclic Peritoneal Dialysis (CCPD). Kidney dialysis equipment may be used in dialysis centers, hospitals, or home care settings.

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North America, followed by Europe, dominates the global market for kidney dialysis equipment due to the presence of a large aging population and availability of better health care facilities in the region. In addition, there is a high prevalence of kidney diseases in the region. According to The Centers for Disease Control and Prevention (CDC), a public health institute in the U.S., in 2014, more than 20 million people suffered from chronic kidney diseases. Asia is expected to grow at a high rate in the next few years in the global kidney dialysis equipment market. China and India are expected to be the fastest-growing markets for kidney dialysis equipment in Asia. Some of the key driving forces for the kidney dialysis equipment market in emerging countries are increasing R&D investment, the presence of a large pool of patients, rising government funding, and growing level of awareness among people.

Diseases such as obesity accelerate the incidences of kidney failure. In addition, habits such as smoking lead to an increase in incidences of kidney failure. Increasing patient pool, rising awareness about the treatment of kidney malfunction, and improved government funding are some of the key factors driving the global kidney dialysis equipment market. In addition, the introduction of safer procedures for renal dialysis is driving the market. However, factors such as the high costs involved and lack of skilled professionals to carry out the process successfully, are restraining the growth of the kidney dialysis equipment market.

Growing demographics and economies in developing countries, such as India and China, are expected to create good opportunities for the global kidney dialysis equipment market. The introduction of some new products with better efficiency is also expected to offer good opportunities for the global kidney dialysis equipment market. Rising number of mergers and acquisitions, new product launches, and increasing number of collaborations and partnerships are some of the latest trends that have been observed in the global kidney dialysis equipment market. Complications associated with kidney dialysis are a challenge for the market. Some of the key companies operating in the kidney dialysis equipment market are Baxter International, Inc., B. Braun Melsungen AG, Sorin Group, and Teleflex Medical. Other companies which have a significant presence in the kidney dialysis equipment market include DaVita, Inc., Nikkiso Co., Ltd., Rockwell Medical Technologies, Inc., Gambro AB, Fresenius Medical Care AG & Co. KGaA, Asahi Kasei Kuraray Medical Co., Ltd, NxStage Medical, Inc., Aksys Ltd., and Diaverum.

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Key Points Covered in the Report

• Market segmentation on the basis of type, application, product, and technology (as applicable)
• Geographic segmentation
  • North America
  • Europe
  • Asia
  • RoW
• Market size and forecast for the various segments and geographies for the period from 2010 to 2020
• Company profiles of the leading companies operating in the market
• Porter’s Five Forces Analysis of the market

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Actress and BJP leader Locket Chatterjee on Tuesday filed a Right to Information (RTI) petition seeking details from the health department about the "VVIP dog" that a senior Trinamul leader had allegedly referred to the state's premier government hospital for dialysis. But the petition doesn't ask the most obvious question: whose dog was it?

In her petition to the public information officer in the directorate of health, Locket has sought answers to five questions:

? What type of pet it was?

? Who brought the pet to the hospital?

? Who made the ticket for treatment?

? Under whose control the treatment was started?

? What type of medicine was given to the pet?

Sources at SSKM and the University of Animal and Fishery Sciences said there was confusion over the ownership of the Golden Retriever that was to be taken to the state-run hospital from the veterinary centre on June 10. They said the dog had been referred to as "unknown" in the SSKM document that contained a list of medicines required for the proposed dialysis.

Petitioner Locket said the dog's owner could be identified once it was known who took it to SSKM. "I read the news of a dog being taken to SSKM Hospital for dialysis. I was shocked because the same machine that is used for human beings would be used for a dog. I went to SSKM on Monday and enquired about who brought the dog. It is clearly mentioned in the hospital's registry book that the dog is a VVIP but the owner's name is not there," she told Metro.

"Obviously the name of the owner cannot be disclosed because he or she is a VVIP. When I asked the hospital staff members about the dog's identity, they kept mum. But nobody denied that a dog was indeed brought for dialysis. I have filed the RTI so that we can find out who brought the dog to the hospital and why did the hospital authorities allow that to happen. This is shocking.... The questions laid down in the RTI (petition) would answer who got the dog to the hospital. Once we find that out, we will find the owner too," added the actress, who quit Trinamul to join the BJP in February.

The answers could take months to come, if they do at all. There are over 12,000 petitions pending in Bengal, which is about 70 per cent of the total papers filed, officials in the state information commission said.

Under the RTI Act, the information officer is supposed to forward a petition to the department concerned and ask it to provide the information sought by the applicant within a fortnight. The information officer gets a month to pass on the information to the petitioner.

"If the department fails to provide the information within a fortnight, the information officer will apprise the petitioner of it. The petitioner has the right to move court, leading to proceedings against the said department in accordance with the RTI Act," said high court advocate Subroto Mookerjee.

Doctors at SSKM and the University of Animal and Fishery Sciences in Belgachhia said senior Trinamul leader Nirmal Maji, who is also the president of the West Bengal Medical Council, had taken the initiative to arrange for dialysis on a Golden Retriever that had had surgery at the vet hospital.

Maji contested the allegation. "I am a doctor and was a kriti chhatra (good student) at Calcutta Medical College. I know very well that a dog can't have dialysis in a hospital for humans. I have nothing to do with it," he said on Tuesday.

Sources said that on the morning of June 10, Arpita Roychowdhury, associate professor of nephrology at SSKM, received information in the outpatient department that a dog was to be brought for dialysis.

Roychowdhury, the sources said, immediately tried to contact the head of the department, Rajendra Pandey, but was unable to do so because he was on leave. She then called Pradip Mitra, the then director of the Institute of Postgraduate Medical Education and Research (IPGMER).

Mitra was transferred a few days after the incident and subsequently put on compulsory waiting by the health department for refusing his new assignment as principal of Sagore Dutta Medical College and Hospital in Kamarhati.

Mitra said on Tuesday that nephrology head Pandey had sent him a text a few days before the dog-dialysis episode, asking him to provide "administrative guidance".

"Some people met me and I asked them whether the vet hospital was equipped for dialysis. When they said they didn't have any such facility, I assured them that we could provide technical guidance. There was no discussion about bringing the dog here," Mitra recounted.

He said Roychowdhury called him on June 10, informing him about the "request" and that she was not ready to allow a dog to be put on dialysis at SSKM. "I asked her to refuse on technical grounds and she did so."

Pandey insisted he didn't have any communication with anyone, including Mitra, about the dog dialysis.

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On June 26, 2015, the Centers for Medicare & Medicaid Services (CMS) released its proposed rule to update the Medicare end-stage renal disease (ESRD) prospective payment system (PPS) for calendar year (CY) 2016. CMS anticipates that the proposed rule would increase overall Medicare payments to ESRD facilities by 0.3% ($20 million) compared with CY 2015 payments. The proposed CY 2016 ESRD PPS base rate of $230.20 would be a $9.23 reduction from the CY 2015 base rate of $239.43. The proposed rule would, among other things, modify case mix and low-volume payment adjustments and update outlier Medicare Allowable Payment and fixed dollar loss amounts. CMS also proposes a variety of updates to the ESRD Quality Incentive Program (QIP) for payment years 2017 through 2019, including changes to the reporting measures and revisions to the Small Facility Adjuster. Furthermore, in conformance with the Protecting Access to Medicare Act of 2014 (PAMA), the proposed rule would establish a drug designation process for: (1) determining when a product would no longer be considered an oral-only drug; and (2) including new injectable and intravenous products into the bundled payment under the ESRD PPS (under current statutory provisions, payment for oral-only ESRD drugs cannot be made under the ESRD PPS prior to January 1, 2025). CMS will accept comments on the proposed rule until August 25, 2015. The official version of the rule will be published on July 1, 2015.

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The Centers for Medicare & Medicaid Services continues to prod providers into adopting electronic health records and electronic data sharing, this time in its proposed 2016 payment rule for end stage renal disease (ESRD) facilities.

The rule, released June 26, doesn't yet require ESRD facilities to adopt EHRs. However, toward the end of the proposed rule, HHS puts facilities on notice that it is moving all providers in that direction.

"HHS believes that all individuals, their families, their healthcare and social service providers, and payers should have consistent and timely access to health information in a standardized format that can be securely exchanged between the patient, providers, and others involved in the individual's care," the proposed rule states. "Health IT that facilitates the secure, efficient and effective sharing and use of health-related information when and where it is needed is an important tool for settings across the continuum of care, including ESRD facilities."

The rule references the Office of the National Coordinator for Health IT's interoperability roadmap and the draft version of its 2015 Interoperability Standards Advisory. The proposal also alerts ESRD facilities that their EHR adoption may be expected in the future.  

"We encourage stakeholders to utilize health information exchange and certified health IT to effectively and efficiently help providers improve internal care delivery practices, support management of care across the continuum, enable the reporting of electronically specified clinical quality measures, and improve efficiencies and reduce unnecessary costs," CMS states. "As adoption of certified health IT increases and interoperability standards continue to mature, HHS will seek to reinforce standards through relevant policies and programs."

CMS explains further in its fact sheet about the rule that it's one of "several" for 2016 "that reflect a broader Administration-wide strategy to deliver better care at lower cost by finding better ways to deliver care, pay providers, and use information." 

The proposed skilled nursing facilities payment rule, released in April, also encourages those facilities to adopt EHRs and share information, using language very similar to that in the ESRD rule. Several new payment initiatives already require EHR adoption and Meaningful Use participation despite indications that physician adoption appears to have stabilized.

Comments on the rule are due by Aug. 25.

To learn more:
- read the proposed ESRD rule (.pdf)
- here's the fact sheet

Related Articles:
EHRs embedded in payment rules for non-MU providers
Survey: Doc EHR adoption leveling off
Providers: Be prepared for 'EHR creep'
CMS oncology care model requires Meaningful Use participation
New HHS initiative places heavy emphasis on EHR use

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