[Congressional Record Volume 142, Number 62 (Tuesday, May 7, 1996)]
[Extensions of Remarks]
[Pages E723-E724]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




    PREVENTION OF PROGRESSION TO END-STAGE RENAL DISEASES--H.R. 1068

                                 ______


                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                          Tuesday, May 7, 1996

  Mr. STARK. Mr. Speaker, last year I introduced legislation, H.R. 
1068, designed to reduce the onset of end-stage renal disease [ESRD] in 
millions of Americans who suffer from kidney disease. Today, I 
reiterate the need for this important measure that will work to keep 
kidney disease patients off dialysis and cause savings for the Medicare 
Program. With the establishment of the demonstration project that this 
bill proposes, patients will be accurately assessed to see what 
management services can prevent the progression of renal

[[Page E724]]

disease and delay the onset of dialysis. The ESRD Program, that is a 
part of the Medicare Program, currently serves about 200,000 
beneficiaries at an estimated total per patient cost of $51,000 a year.
  The question that the 3-year demonstration program will work to 
answer is if the costs of applying preventive services to ESRD patients 
will delay the onset of complete renal failure, thus causing an 
increase in the quality of life of patients and a net savings to 
Medicare expenditures which is larger than the cost of the preventive 
services. One recent study has affirmatively answered this question. A 
recent report published in the Annals of Internal Medicine concluded 
that a reduction of protein in patient's diets will slow the 
progression of chronic kidney disease.
  The report cited five separate studies of nondiabetic patients who 
showed a 30-percent reduction in complications with the low-protein 
diet. A recent publication by the Iga Nephropathy Support Network 
reported that patients who reduced meat consumption, saved the kidneys 
a lot of hard work in clearing the body of the byproducts of protein 
metabolism. With 20 million Americans suffering from kidney and urinary 
tract diseases, these findings are monumental and a clear example of 
the need to provide funding for preventive services. A spokesperson for 
the National Kidney Foundation said that the recent breakthroughs in 
preventive care, ``* * * not only helps the individual, but in the 
long-term it keeps patients off dialysis * * * saving money.''
  With an increasing number of patients entering the ESRD Program, this 
legislation is necessary for the containment of costs for treating 
dialysis dependent patients. Also, the high unemployment rate among 
patients who require dialysis to live will decrease as patients are 
able to stay in the workforce longer because of the careful management 
of their disease. With all of these suggestions about the benefits of 
prevention care and management, we must establish the demonstration 
program provided by this legislation.

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