Opinion: Surfing, camping, and deciding when to stop: Australia’s human-centric approach to dialysis
“We let people dialyze to live, rather than living to dialyze,” says John Agar in this excerpt from Tom Mueller’s “How to Make a Killing.”
In 1972, as Congress promised dialysis and rehabilitation for all kidney failure patients in America, Australia was passing its own law to guarantee universal dialysis coverage. Since then, Australia and America have traveled very different paths, in dialysis and in health care as a whole.
Most leading nephrologists worldwide agree that dialysis should ideally be delivered in long, frequent sessions at low ultrafiltration rates, and be carefully tailored to each patient’s physiology. Large dialysis companies, by contrast, frequently employ what John Agar, the Australian nephrologist, calls “bazooka dialysis”: treatment in brief, high-speed bursts following a one-size-fits-all protocol. Nephrologists who order longer treatments or make other customizations of their patients’ dialysis prescriptions may encounter obstruction by clinic management.
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