Dialysis treatment plays vital role

Rodolfo V.

Hernandez considers himself a fortunate man.

A dialysis patient for 2.5 years, he missed outpatient treatment last week because he did not feel up to going, he said.

The following day he was admitted to Kingman Regional Medical Center with toxins building up in his blood.

He underwent treatment in the hospital's acute hemodialysis unit and went home the following day.

"If they had not had dialysis available at the hospital, I would have died," Hernandez said.

Hernandez regularly gets outpatient dialysis treatments in Kingman.

But in the past he has been transferred to a hospital in Las Vegas for the treatment he urgently needed.

"I've had many angiograms in the past, and a doctor in Las Vegas told me the reason for my kidney problems is all the dye they put through my heart had messed up my kidneys," Hernandez said.

Registered nurse Linda Pace is dialysis coordinator at KRMC.

She said she and Dr.

Narayana Murty, a nephrologist, began a dialysis unit at the hospital in 1996 under a contract with Fresenius, a dialysis company.

But by 2000, Fresenius officials decided they could no longer operate the unit at KRMC, so the hospital canceled its contract with the company and took over the dialysis unit, said Marty Cowan, director of development and community relations for the KRMC Foundation.

Putting in state-of-the-art equipment was an important step toward opening the unit full-time.

The hospital bought two Fresenius 2008K machines, each for about $16,000, and two reverse osmosis machines, each for about $5,000, to link to the Fresenius machines.

Artificial kidneys for one-time use during blood cleansing cost $97 apiece.

Blood tubing, transducers and saline all add to the price tag.

In June, the acute hemodialysis unit began operating as a separate department of the hospital.

Dr.

Damaso Bueno is the medical director.

Dr.

Vijayavel Palanichamy is another nephrologist who sends patients to the unit, Pace said.

Irma Siva is a patient care technician, who oversees treatments.

"There are a number of reasons why someone might need dialysis," Pace said.

"They include myocardial infarction (heart attack) or congestive heart failure.

Clotted access to a catheter would be another reason."

Kidney patients normally undergo dialysis on an outpatient basis three times a week, Pace said.

But they may need four consecutive days of treatment as an in-patient, she said.

Treatments usually take 3-4 hours.

Up to four patients per day per machine can be treated at KRMC.

Men normally require longer treatment than women because of their muscle mass, Pace said.

But an individual's weight, lab results and severity of condition are other factors in treatment.

Different solutions or "baths" specify an electrolytic content to maintain the equilibrium of a patient's chemistry.

Potassium and calcium are main chemicals infused during treatment, but others include sodium, magnesium, chloride, acetate and dextrose.

"We also use a bicarbonate we mix ourselves to maintain an acid base for a patient," Pace said.

While the Fresenius machine is cleansing the patient's blood, the reverse osmosis machine removes unwanted minerals such as calcium and iron from water going through the system.

Patients who come into acute settings often are in renal failure and have never before had dialysis, Pace said.

Some require aggressive treatment to remove toxins in the blood.

"We're usually a little slower (in terms of patient numbers) in the summer," Pace said.

"In the winter, there are more viruses going around so we have a heavier load.

"We're now providing a service that is wonderful.

It's a hardship any time you have to have a patient flown out to another location."

Hernandez agreed, saying the in-patient acute dialysis unit at KRMC is very convenient.