Hooked up, for life

Hooked up, for life

JOHN ROBBINS
The Review

Saturday, May 26, 2007 - 07:00

Local News - The tubes sprouting from Frances Niven's chest are her lifelines.

As she reclines in a chair on the third floor of Niagara Health System's Ontario Street site in St. Catharines, she watches her blood slowly pump in and out of her body through a machine that rids it of the toxins that would kill her if she didn't submit to the life-giving therapy.

"That's my kidney," the smiling 60-year-old Niagara Falls woman says, pointing to a cylinder on one side of the machine.

"That's what keeps me going."

Niven is one of 75 Niagara Falls residents who travel to St. Catharines or Welland for regular kidney dialysis treatments.

If the health system's plan to open a satellite dialysis centre at Greater Niagara General Hospital by 2010 come to fruition, Niven's road trips will be a thing of the past.

Chronic kidney disease refers to progressive, and usually irreversible, deterioration of a person's kidney function.

A number of illnesses and medical conditions can lead to chronic kidney disease - which used to be called end-stage renal disease - such as diabetes, hypertension and cardiovascular disease.

When the kidneys fail or their function is significantly impaired, dialysis is used to take over the job of filtering harmful wastes and fluids out of a patient's blood.

There are two primary types of treatment: Hemodialysis, which uses a machine to mechanically filter blood; and peritoneal dialysis, which involves using the lining of a patient's abdomen (peritoneal membrane) as a filter.

Dialysis is not a cure for chronic kidney disease, but a treatment to prolong life and maintain health.

While some patients eventually receive a kidney transplant, many others remain on dialysis for the rest of their lives.

Continuing advances in medicine mean patients whose kidneys have failed are living longer than ever before. That's one reason why the number of Canadians requiring regular dialysis treatment is steadily climbing. The growing percentage of the population age 65 and over is another reason for higher demand for treatment.

According to a June 2003 needs-assessment study by the Niagara District Health Council, the percentage of Niagara residents over 65 is roughly 17 per cent, compared to the Ontario average of 12.9 per cent.

Niagara has the fourth-highest incidence rate for chronic kidney disease in Ontario. Current projections show a need for expanded dialysis treatment services here, said Anne Atkinson, the health system's vice-president of patient services.

Atkinson said the number of Niagara patients on hemodialysis is expected to increase nearly threefold, to 667 in 2013 from 221 that were receiving the treatment in 2000.

The number of peritoneal dialysis patients is expected to jump to 222 from 65 during the same time period.

The Ontario Ministry of Health and Long-Term Care's goal is to have 30 per cent of dialysis patients receiving treatment at home. Even so, Atkinson said, hospital-based dialysis treatment has to grow to keep up with the influx of new patients.

At one time, patients from across Niagara had to travel to St. Catharines for treatment.

But two years ago, the health system opened a satellite treatment centre at its Welland hospital.

Atkinson said the decision to open a satellite centre - as opposed to just continually expanding services in St. Catharines - was aimed at improving the quality of life for the many patients living in the southern half of the peninsula who have to drive or find a ride to the Ontario Street site and back.

"We want to have the patients (receive treatment) as close to home as possible," said Atkinson.

"When you have people with chronic disease, the more you can provide services close to home the better."

Currently, there are 40 hemodialysis stations at Ontario Street and 17 more at the Welland hospital.

Atkinson said the NHS has applied to the ministry for approval to open a 12 to 15-station satellite program at Greater Niagara General Hospital by 2010.

"There's definitely a need for this service in Niagara Falls," said Jane Cornelius, manager of the health system's chronic kidney disease program.

Cornelius said the average age of patients receiving dialysis is 67. Many either can't drive or find it difficult to travel distances because of their age and health problems.

Because of a lack of public transportation, most patients who can't drive themselves have to rely on relatives to get to and from treatments.

That's the case for Niven, who lives in the north end of Niagara Falls.

She has been making the half-hour trip to St. Catharines for dialysis treatment three times a week for more than 18 months. Most of the time, her husband drives her, then comes back to pick her up after her four-hour treatment. Because her husband still works, it's a difficult juggling act to perform week in, week out.

And then there's the cost factor.

"With the price of gas these days, it starts to add up," she said.

Other complications arise from time to time. Earlier this year, Niven was admitted to hospital in Niagara Falls. Since missing her dialysis treatments isn't an option, she had to be shuttled back and forth between the Niagara Falls and St. Catharines hospitals throughout her hospital stay.

While she has grown close to many of the staff and patients at the Ontario Street site, Niven said she looks forward to the day when she can go to GNGH.

"Just as long as I can bring my nurses with me," she chuckles.

jrobbins@nfreview.com