I work for a small dialysis company owning about 12 centers.We try very hard to get our URR's up the best we can.It has come to my attention from other Dialysis Nurses working for large chains "They use larger kidneys on blood draw day "Thus defeating the whole "dialysis Compare" Mr.Thompson needs to look into this.They are playing with the numbers.I have looked at some of the numbers out there and some are very unrealistic and this explains it.

Sounds like to them patients' lives are a game. I've heard other figures are scrambled, too.

I'd like to know what "As Expected" means, and how they determine how many deaths per year are acceptable. Wouldn't it be better to show stats on how many patients in a unit are diabetic?

Using larger kidneys on the day of dialysis will have no effect on URR's since they are drawn prior to treatment.

Concerned Professional,

The dialyzer plays a MAJOR role in the URR. The URR is derived from a Pre BUN and a Post BUN. The formula for it is:

Pre-Post/Pre x 100 = %Reduction

If this or any other "scrambling" of numbers is happening and can be proven...it should be reported because it would probably be considered "Medicare Fraud".

The unit I go to uses the same dialyzer. The neph. writes the prescription for what type, size, ect. If I ever see a deviation I will certainly question it!
As always Chuck, you're right on the mark. Lin.

I would like to know how Deborah came across this information? I have never seen or heard of this and (if it does happen) would suggest that the patients at the facilities call the licensure board and file charges not only againist the nurses but if documentation would support it the nephrologist also. Dialyzers are (as Lin pointed out) a prescription item, changing them without orders is unacceptable and if the neph has different orders just on lab day I would think someone would question it. I would also like to know what Deborah considers unrealistic numbers? Were these comments and accusations made just out of frustration (due to low URR's at her facility)?

DEBORAH GOT THIS INFORMATION FROM NEPHROLOGY NURSES WHO LEFT THOSE CHAINS FOR ONE REASON OR ANOTHER.I WAS SHOCKED TO HEAR THIS ALSO BUT IN READING SOME OF THE COMMENTS FROM PATIENTS IN THIS DISCUSSION BOARD THERE ARE DIALYSIS STAFF OUT THEIR CHEATING PATIENTS IN MANY WAYS.I HAVE BEEN IN DIALYSIS 20 YEARS CNN MY JOB IS MORE THAN A JOB ITS MY CAREER AND I LOVE IT BUT WE ALL KNOW THERE ARE PLENTY OF PEOPLE OUT THEIR WORKING FOR THE DOLLAR.(THAT SHOULD BE RETIRED)AND THOSE ARE THE ONES THAT DON"T EVEN KNOW THIS WEB SITE EXISTS.Am I FRUSTRATED AT MY LOW NUMBERS
77-82 ARE MY URR'S NOT THE BEST BUT WITH BAD STICKS CATHETERS AND EVERYDAY PROBLEMS I KNOW MY NUMBERS ARE REAL AND i ALWAYS TRY TO MAKE THEM BETTER.BUT 95 CONSISTANTLY COME ON.