As an accomplished athlete who has successfully lived on kidney dialysis for almost three decades, and one of the leading advocates for the renal community, I find myself in a position where I need to issue a statement publicly about a decision currently being considered for implementation by CMS that will adversely impact the renal community and increase our long term Medicare costs significantly. I must respectfully insist that CMS reinstate the sub-10 hemoglobin metric as part of the QIP.

There are currently 600,000 Americans on kidney dialysis with an additional 25 million Americans living with CKD, Chronic Kidney Disease. Another 21 million Americans have the disease, and they are walking around unaware that their kidneys are failing! Kidney Disease is significantly growing in the United States due to the increase of obesity, high blood pressure, and diabetes. There are over 133 million Americans who are considered obese or overweight, with an additional 54 million Americans predisposed to developing Type II diabetes, and millions of Americans who have undiagnosed and or untreated high blood pressure.

The financial impact of this disease on our society is significant and the tough decisions we are left to make require us to take pause, and reconsider our approach as to how we have traditionally delivered healthcare in this country. We have a reactionary approach to delivering care yet we struggle to understand that this is systemically a chronic issue.

I recently read an article in the USA Today written by Rita Rubin where she quotes Barry Straube, chief medical officer at the federal Centers for Medicare & Medicaid Services, “25 million Americans have kidney disease, but Medicare benefits don’t kick in until patients are at the most advanced stage. Many patients with earlier-stage kidney disease aren’t treated for high blood pressure or diabetes, which cause two-thirds of kidney failures.” The article goes on to quote other distinguished and respected individuals within the renal community, J. Michael Lazarus, Fresenius’ chief medical officer, says: “Every nephrologist would love to see patients earlier. But nobody sends them. … I’ve seen them in the emergency room at the end. That’s because many rarely have seen any kind of doctor, let alone a kidney specialist.”

The article began with the following statement, which lends support to my point; The End Stage Renal Disease Program doesn’t address prevention, a major focus of the health care debate.

The key to cost reduction is patient stabilization. This can be achieved through patient education, awareness & prevention, and access to first line therapies and first line medications. The invention and use of ESA’S saved the lives of hundreds of thousands of patients including mine. It has given me the ability to successfully live with this disease because it is a part of my healthcare team’s overall medical treatment approach to stabilizing my disease. When hemoglobin is kept within the recommended 10-12 g/dl target range the patient’s anemia stabilizes to a point where they feel better and have the energy to start the long road back to rebuilding a stable and successful life with kidney disease.

One point I would like to make is that the amount of ESA I require has gone down over the years as my health has stabilized. I attribute that specifically to the combination of great anemia management and cardiovascular exercise. One of the many benefits I have seen is the reduction of hospitalizations I have experienced. (Only three times in the past nine years) People given a renal diagnosis, especially those on dialysis, can on average expect to be hospitalized 4 to 6 times per year totaling 15 days. Arguably, the costs of hospitalizations far outweigh the costs of providing first line therapies and first line medications to kidney disease patients. Should we not be focused on the true culprit?

By removing the sub10 hemoglobin metric and not reinstating it as part of the QIP we can and will see the following:

• An increase in the use of blood transfusions
• A decrease in eligible transplant patients due to blood sensitivity
• An immediate change in the stabilization of the disease
• Decreased anemia management
• An increase in co-morbid conditions due to the sedentary activity levels of patients given a renal diagnosis
• Unnecessary and extraordinary burden will be placed upon the health care eco-system (Patient/Physician/Provider) as this singular cost savings approach becomes the driving factor

Sometimes we are unable to see the forest for the trees. More and more often we find ourselves “reacting” to the national healthcare situation that presents itself. Our problems stem from the fact that we are all symptomatic to the disease, NOT the therapy. We have a responsibility to the stewardship of our healthcare dollars and the broadest possible impact those dollars can have in the delivery of life saving therapies. Without the sub-10 hemoglobin metric being reinstated as part of the QIP I am afraid that we will lose any chance of stabilizing one of the major co-morbid conditions (anemia) and ultimately the disease itself. The results will be catastrophic, as this singular approach to better managing our healthcare dollars will ultimately deliver a significant increase in Medicare expenditures.

I was left to draw on my extensive personal experiences before the invention of ESA’S while I considered both sides of the debate. I remember having to live with a hemoglobin below 10g/dl and the magnitude of blood transfusions it took to keep me alive and barely functional. These experiences have led me and my organization to take the following position regarding this issue; the sub-10 hemoglobin metric needs to be reinstated as part of the QIP.

Sincerely,
Shad Ireland- Executive Director
Shad Ireland Foundation- Impact Focused, Technology Driven
www.shadirelandfoundation.org

Ireland will speak to hundreds of people affected by kidney disease at the Renal Society of Australasia annual conference on June 9 in Adelaide, Australia

June 2, 2012 – Atlanta, GA – Following a grueling week in May where Ironman Triathlete and dialysis patient Shad Ireland rode three stages of the Amgen Tour of California professional cycling race to launch “Taking on the Tour,” the dynamic Ireland heads across the globe to Australia to continue the awareness campaign for kidney disease. On June 9, Ireland will speak to hundreds of people affected by kidney disease, including patients, nurses, doctors, social workers, dieticians, and other health care professionals at the Renal Society of Australasia annual conference in Adelaide.

At the conference, Ireland will speak to members about his 29-year battle with kidney disease and how he overcame all obstacles to be the first dialysis patient to successfully complete an Ironman triathlon. As part of “Taking on the Tour,” a 24-month athletic endeavor to conquer the sport of cycling and raise awareness for kidney disease, Ireland will return to Australia on January 21, 2012 to ride about 135 kilometers in the community challenge of the Santos Tour Down Under. Following the ride, Ireland will visit several cities in the region in an effort to inspire people and spread the message that no matter what challenges they face, anything is possible.

“By riding in the Santos Tour Down Under in Australia, I hope to inspire people in this country as well as the millions affected by kidney disease across the world to take action and get healthy,” said Ireland. “My biggest goal is to show those who are suffering that anything is possible, no matter the obstacles.”

Ireland, best known for his epic 4,700 mile ride across the U.S. in 2009 to bring attention to those with kidney failure, is riding multiple stages the world’s toughest cycling races and plans to compete in the Orange County Triathlon and the New York City Marathon, all in an effort to spread the message of healthcare and prevention as well as to raise awareness of the millions of people afflicted by kidney disease worldwide.

A dialysis patient since the age of 10 and living with no kidneys, Ireland is a passionate advocate for kidney disease prevention through exercise and healthy living. His mission is to inspire others to accomplish anything, no matter what the challenge, and to educate people to exercise as a way to prevent kidney disease as well as obesity, high blood pressure and diabetes, which are the leading causes of the disease.

For more about the “Taking On the Tour” initiative, or to donate to the Shad Ireland Foundation please visit www.takeonthetour.com or www.shadirelandfoundation.org

About The Shad Ireland Foundation

Global Mission: Committed to education, prevention, awareness, and access, the Shad Ireland Foundation is an international non-profit organization that is actively exploring ways to further develop and expand its global impact on kidney diseases and their leading causes. In countries around the world the Foundation is developing and creating strategic relationships that will lead to the development of tools and resources, which will ultimately and positively impact individuals, families, and communities affected by, and or living with this disease.

About the Santos Tour Down Under

The first stop on the world cycling calendar, the Santos Tour Down Under is a week-long multi-stage professional cycling race, which typically begins in Adelaide and travels through regional South Australia each January. The Santos Tour Down Under will take was first held in 1999 and has grown year on year to become the biggest cycling race in the southern hemisphere. In 2012, the race takes place from January 15- 22.

Media contacts:
Martine Charles & Katrina Younce Sports PR
T: 206-295-9114 T: 310-995-3619

martine@sportspr.com
katrina@sportspr.com

Click to view the PDF
Kidney Community Newsletter June 2011

Triathlete and Dialysis Patient embarks on 24-Month Mission to Ride Stages of Every Grand Cycling Tour in Quest to Bring Awareness to Kidney Disease

WHAT:

Triathlete Shad “Ironman” Ireland, the first kidney dialysis patient to ever complete an Ironman triathlon, will be in Boulder, Colorado from April 19 – 20 to prepare for the Amgen Tour of California. Ireland will ride with world-class triathletes and Colorado residents Julie Dibens, Chris Legh and Tim O’Donnell as part of his training for the grueling race. The Amgen Tour of California marks the start of Ireland’s “Take on the Tour” initiative, a 24-month campaign to raise awareness of kidney disease prevention through exercise and healthy living. As part of the initiative, Ireland will ride multiple stages of the world’s toughest cycling races to raise awareness of the 27 million Americans suffering from kidney disease.

Ireland will also visit Children’s Hospital in Denver to reconnect with youngsters who have recently had kidney transplants and children on dialysis. He hopes to provide encouragement and information to the children and their families.

WHO:

• Shad Ireland, Ironman triathlete, dialysis patient and advocate for kidney disease prevention
• Julie Dibens – Professional triathlete, Ironman 70.3 World Champion, 3x XTERRA World Champion
• Tim O’Donnell – Professional triathlete, ITU Long-Course World Champion, Ironman 70.3 U.S. Pro Champion
• Chris Legh – Professional triathlete, Ironman Champion and 6x Australian National Champion

Read the full story here.