Dialysis: Part miracle, part ball and chain

Dialysis: Part miracle, part ball and chain
Bill may add funding, push prevention

By Kathy Aney
The East Oregonian
11/7/2007

Bacilio "Rich" Yzaguirre is one of more than 20 million Americans who suffer from kidney disease. He also has membership in an even more exclusive club - he's one of 320,000 people who have end-stage renal disease and must endure dialysis treatments to stay alive.

The Hermiston man listens to Janis Joplin and Melissa Ethridge while he endures four-hour blood cleansing treatments three times a week. As he lounges in the hospital version of a chaise lounge, he is tethered to an artificial kidney machine that filters his blood, removing toxins and fluid.

More and more people are joining Yzaguirre every year. Because of rising diabetes and hypertension rates, the number of individuals with end stage renal disease is expected to roughly double in the next decade.

The disease is costly and leaves many reliant on Medicare.

"Very few people come with insurance," said Kelly Kelley, who manages FMC Dialysis in Hermiston. "The cost is huge and it's for the rest of their lives, most of them."

Yzaguirre, 60, has undergone dialysis at the clinic three times weekly for two years. The 60-year-old rested in one of 12 dialysis chairs recently, flanked by a dialysis machine, replete with dials and digital readouts. A 15-gauge needle protruded from his elbow, which is mottled purple. Blood flowed through tubing, then a semi-porous membrane, into the machine and then back into Yzaguirre.

Other dialysis patients occupied the remainder of the dozen chairs at the clinic. They settled in for the long haul, some reading, others dozing.

Yzaguirre, a diabetic, said his kidney function dropped steadily over the past several years until finally his only option was dialysis. By that time, it was obvious his kidneys had packed it in.

"I couldn't put shoes on - I was so swollen," he said. "I had to cut the sides of my Levis to get my legs in, I was retaining so much water."

The skyrocketing numbers of obese and diabetic Americans don't bode well. Both conditions often lead to kidney disease.

Sixty percent of Oregon's 2,500 dialysis patients were previously diagnosed with diabetes or hypertension, according to the Northwest Renal Network.

Yzaguirre discovered he had diabetes at age 17. He fought obesity most of his life.

"I weighed 300 pounds when I was in the 6th grade," he said.

Yzaguirre, a former theater manager, dropped to about 200 pounds after his doctor informed him he was headed for dialysis.

Many dialysis patients wait for kidneys to replace their faulty organs.

"There's a huge need and very few available," Kelley said. "Sixty-two thousand are currently waiting for kidney transplants."

Congress is now considering the Kidney Care Quality and Education Act of 2007 as a way to stem the tide of kidney disease. Passage would fund an early intervention program aimed at Medicare patients who have diabetes or high blood pressure and automatically bump Medicare funding each year to adjust for prices and inflation.

"Proper education and management of chronic diseases - like hypertension and diabetes - can often help patients avoid kidney failure altogether," said Dr. Edward Jones, nephrologist and chairman of Kidney Care Partners, a coalition of patient advocates, dialysis professionals, care providers and suppliers that is backing the legislation.

Weight control, healthy diet, medication to control high blood pressure and early detection will ward off or slow the progression of kidney disease, advocates say.

Yzaguirre wishes he would have gotten serious about prevention earlier in his life and possibly avoided his dependence on dialysis.

Dialysis can be exhausting, as well as expensive.

"After you get off the machine, you are drained," Yzaguirre said. "You go home and crash."

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Staff photo by E.J. Harris Bacilio "Rich" Yzaguirre has 4-hour dialysis sessions three times a week at Fresenius Medical Care Dialysis in Hermistion.