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Sensing Savvy

Deborah Brouwer-Maier RN, CNN

Deborah Brouwer-Maier is a nephrology nurse for more than 30 years. Her area of expertise is hemodialysis vascular access. She served on the KDOQI Vascular Access Work Groups in 1997, 2000 and 2006. She also served in various volunteer roles for the Fistula Frist Initiates since the formation of the initial Work Group. She is the support for the Hemodialysis Circle of Care Transonic products to support access creation, surveillance and preservation.

Recent Posts

What to Know About the Advancing American Kidney Health Executive Order

Posted by Deborah Brouwer-Maier RN, CNN on Nov 6, 2019

President Donald Trump signed an executive order in July  designed to “improve the lives of Americans suffering from kidney disease, expand options for American patients, and reduce healthcare costs.”

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Kidney Care News to Know

Posted by Deborah Brouwer-Maier RN, CNN on Nov 4, 2019

Fresenius Invests in BioIntelliSense

Fresenius Medical Care North America has invested in BioIntelliSense, a remote, continuous health monitoring data platform that provides predictive analytics, clinical insights and real-time data through a medical-grade sensor. With its investment, Fresenius hopes “to improve monitoring, treatment and outcomes for patients with kidney disease.”

Source: Nephrology News & Issues

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Kidney Care News to Know

Posted by Deborah Brouwer-Maier RN, CNN on Oct 2, 2019

Large Dialysis Providers have Strong Growth in Home Dialysis

According to a survey from Nephrology News & Issues, the 10 largest dialysis providers had 35% of patients on home dialysis, that‘s 15 percentage points higher than survey results from 2018 and 2017. Among the providers, home hemodialysis grew from 5,783 patients in 2013 to 8,807 patients in 2019.

Source: Nephrology News & Issues

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Kidney Care News to Know: Fresenius Invests in BioIntelliSense

Posted by Deborah Brouwer-Maier RN, CNN on Aug 14, 2019

Trump Administration Announces Plan to Change Kidney Care in the U.S.

President Trump signed an executive order to launch Advancing American Kidney Health, which is designed to increase earlier intervention, incentivize dialysis providers to direct more patients to home hemodialysis and increase the number of kidneys available for transplant.

Specifically, the initiative aims to:

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Hemodynamic Monitoring: Updated Cardiac Function Parameters

Posted by Deborah Brouwer-Maier RN, CNN on Aug 12, 2019

Hemodialysis patients who do not feel well at the end of a session are subject to an unidentified decrease in Cardiac Index. End-stage renal disease (ESRD) patients are at increased risk of complications and death from cardiovascular disease (CVD). In fact, mortality rates from CVD are up to 30 times higher for ESRD patients than those in the general population.

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Kidney Care News: Outset Medical Appoints New Chief Financial Officer

Posted by Deborah Brouwer-Maier RN, CNN on Jul 31, 2019

Outset Medical Appoints New Chief Financial Officer

Rebecca Chambers is the company’s new CFO. Prior to joining Outset Medical, Chambers worked at Illumina Inc.

Source: Nephrology News & Issues

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Home Hemodialysis: A Brief History

Posted by Deborah Brouwer-Maier RN, CNN on Jul 10, 2019

In the early 1960s, the demand for dialysis outweighed its availability, which meant many patients with end-stage renal disease (ESRD) or chronic kidney disease were turned away from treatment.

After the 15-year-old daughter of a friend of Les Babb’s was denied dialysis treatment, Babb, a professor of nuclear engineering at the University of Washington and Belding Schriber set to work developing a small home dialysis system. A few months later in London, Stanley Shaldon began using a similar machine to treat dialysis patients at home.

Since there was no government funding to pay for treatment in the ’60s, home hemodialysis became an affordable treatment option for patients.

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Kidney Care News to Know: CPR Underused by Dialysis Clinics

Posted by Deborah Brouwer-Maier RN, CNN on Jun 24, 2019

California’s Legislation of Dialysis Profit Restriction Could Cause DaVita to Lose Up to $40 Million

DaVita has estimated it could lose up to $40 million in revenue if California’s restricting dialysis profits and use of third-party payers to cover Medicare premiums becomes law. The company spent $30 million in Q4 2018 in an effort to counter union policy efforts and spent $93 million on advocacy efforts last year.

Source: Nephrology News & Issues

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Debbie Brouwer-Maier Offers Her Perspective on Kidney Care Issues

Posted by Deborah Brouwer-Maier RN, CNN on Jun 7, 2019

As a nephrology professional who has devoted countless hours of volunteer time to support the body of work reflected in the 2006 National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines on vascular access, it is difficult to witness the “march of time” with regards to the arteriovenous fistula (AVF) as the best access for patients on dialysis.

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Topics: KDOQI

Process of Care, Part III: Hemodialysis Catheters

Posted by Deborah Brouwer-Maier RN, CNN on Jun 3, 2019

The same concerns over process of care related to the KDOQI VA proposed changes that reverse the momentum of the past guidelines and Fistula First (identifying early indications of assess dysfunction, staff assessment competency) also apply to hemodialysis catheters. The proposed guidelines suggest that hemodialysis catheters could be a viable long-term access choice. Similar to the limitations on assessment skills, many states restrict the accessing of a central venous catheter to a licensed nurse. Questions raised by the proposed guidelines include:

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