NKF Press Release 4-24-14

New Research Shows Survival Benefit with Daily Dialysis in a Nursing Home Setting

LAS VEGAS, April 24, 2014 /PRNewswire/ -- On Wednesday, April 23, 2014, Affiliated Dialysis Centers, LLC ("ADC") shared the release of clinical data in a Late Breaking Poster Session at the 2014 National Kidney Foundation (NKF) Spring Clinical Meetings in Las Vegas, NV. Xelay Acumen, a strategy and medical data analytics firm, independently led the data collection and analysis effort, and Dr. Alex Yang, M.D. presented the results. Earlier this year, ADC presented the first results of a large epidemiological health outcomes clinical research study involving End Stage Renal Disease (ESRD) patients who received their dialysis care on-site in the nursing home setting. The study utilized the largest known database of ESRD patients receiving dialysis in the nursing home setting, consisting of nearly 4,000 patients tracked over a 6-year follow-up period. In this new study utilizing this clinical database, health status and patient outcomes were compared in nursing home patients receiving daily home hemodialysis vs. conventional thrice weekly hemodialysis.

Patients with ESRD on dialysis have one of the highest mortality rates of any disease, surpassing many cancers. Within this ESRD patient population, nursing home patients typically have even greater health challenges by virtue of their need to be in a nursing home. Thus identifying beneficial treatment paradigms for these patients is a
significant clinical priority.

The key findings from this large epidemiological research study were that, compared to conventional thrice weekly dialysis, patients treated on-site in a nursing home setting with daily home hemodialysis had:

1. Generally improved health status
2. Lower monthly mortality rates
3. Significantly longer median survival (50 months vs 30 months; P<0.001)

"The ADC database is a unique and extremely important research tool, which allows us to study a large population of ESRD patients on dialysis in the nursing home setting and test hypotheses about optimal care and outcomes for this at-risk patient population," said Dr. Yang. "The improvements in health status, and particularly in overall survival, in patients treated with daily home dialysis in this study are provocative and suggest the need for a prospective outcomes study."

Mr. Steven Bucher, Chief Executive Officer of ADC, noted: "ADC is very proud to serve this vulnerable patient population, and deliver high quality health care. Furthermore, we are pleased to be able to contribute to research efforts aimed at identifying best practices and improving care for ESRD patients in the nursing home setting."

Affiliated Dialysis Centers, an independent dialysis provider based in Illinois, is the largest provider of home dialysis in Illinois and a national leader in providing home hemodialysis services to End Stage Renal Disease patients residing in skilled nursing facilities.

For further information, visit the company at www.affiliateddialysis.com, or contact Ms. Kathy Hocking, Corporate Clinical Advisor at k.hocking@affiliateddialysis.com.

Affiliated Dialysis Centers, LLC
Chicago Headquarters: 800 Roosevelt Road, STE E-320 Glen Ellyn, IL 60137 Ph: 630-942-1111

ADC Press Release 2-11-14

New Research Study Shows Significant Improvements in Health Status for Patients on Dialysis in the Nursing Home Setting

ATLANTA, Georgia – On Monday, February 10, 2014, Affiliated Dialysis Centers, LLC (“ADC”) shared its first release of clinical data at the 2014 34th Annual Dialysis Conference in Atlanta, GA. Since 2013, ADC has engaged Xelay Acumen, a strategy and medical data analytics firm, to independently lead the data collection and analysis effort of Affiliated Dialysis Centers clinical data. Dr. Alex Yang MD, presented the initial results from this first ever and large health outcomes clinical research study, representing the largest database of ESRD patients on dialysis in the nursing home setting (~4,000 patients over 6 years).

The ESRD patient population on dialysis already has one of the highest mortality rates, surpassing many cancers. Within the ESRD patient population, nursing home patients have additional health challenges by virtue of their need to be in a nursing home. Transporting these very frail patients from the skilled nursing facility to a dialysis facility, sometimes a great distance in inclement weather, is not only cumbersome, but potentially detrimental to their health status.

Key results from this epidemiological research study demonstrated

1. Poor initial health status in ESRD patients on dialysis in the nursing home setting, confirming the high-acuity of this vulnerable patient population relative to the general ESRD population
2. Improvements in health status during the incident 4-12 months as shown by the improvement in mortality rate, albumin, and hemoglobin, indicated a high level of quality care being delivered:
• Mean Mortality improved from an annualized rate of ~70% to 30%
• Mean Albumin improved from 3.2 to 3.6 g/dL
• Mean Hemoglobin improved from 10.15 to 10.8 g/dL
3. Patient outcomes have improved year over year and in the incident 3 months on dialysis, consistent with the trend and quality of care provided to the rest of the US dialysis population

Further analyses will be conducted to investigate whether different baseline characteristics or changes in clinical practice (eg, daily home hemo vs conventional TIW) correlate with improving mortality rate and health status

“Large nationwide databases such as USRDS that report on Medicare patients do not code for location of dialysis, and therefore the scientific and dialysis community have never had access to such a large and complete database on ESRD patients on dialysis in the nursing home setting.” said Dr. Alex Yang MD. “These initial research results are provocative in that they shed a new light on the high quality of care being provided in the nursing home setting and potentially point to differences in health outcomes such as mortality based on the location of delivery.

”Mr. Steven Bucher, ADC’s Chief Executive Officer, stated “We have made great clinical strides in our ten year focus serving this most vulnerable patient population. We are pleased to be an industry leader delivering great quality care that has a significant impact on these patients. We look forward to sharing more of the analyses at upcoming scientific meetings including an exploration of daily home hemodialysis versus convention thrice-a-week hemodialysis in this population.”

Affiliated Dialysis Centers, an independent dialysis provider based in Illinois, is the largest provider of home dialysis in Illinois and the nation’s leader in providing home hemodialysis services to End Stage Renal Disease patients residing in skilled nursing facilities.

For further information, visit the company at www.affiliateddialysis.com, or contact Curt Anliker, Chief Operating Officer, at (630) 942-1111.

Affiliated Dialysis Centers, LLC
Chicago Headquarters: 800 Roosevelt Road, STE E-320 Glen Ellyn, IL 60137 Ph: 630-942-1111