Dialysis: Providing a life-saving service

A machine keeps Charles Lewis alive. For 12 hours each week – every Tuesday, Thursday and Saturday – Lewis treks to Community Medical Centers’ outpatient dialysis center on the campus of Community Regional Medical Center where a hemodialysis dialysis machine filters toxins from his blood. Sometimes his treatments last as long as five hours.

“It’s like going to a part-time job.” Lewis said.

The 63-year-old Lewis was diagnosed with diabetes more than 24 years ago. And he’s also suffered with complications from the condition, including ulcers on his feet. Eventually he had to have both feet amputated and two prosthesis put in their place. After years of working to control his diabetes, he went into kidney failure and began dialysis in 2007 at the age of 56. He’s been coming to Community Regional’s outpatient dialysis center for almost eight years.

“Without this, I definitely would be dead,” said Lewis. “I couldn’t have made it this far without the help from the people at Community.”

Community is one of the largest non-profit providers of dialysis services in the Central Valley, assisting patients who have damaged kidneys by filtering toxins from their blood. Community provides 37,000 dialysis treatments annually at outpatient clinics at Community Regional and Clovis Community Medical Center, inpatient services at Community Regional, Clovis Community and Fresno Heart & Surgical Hospital and home health services. During hemodialysis, a person is connected to a machine that takes over the kidneys' job of filtering their blood. These treatments are usually needed several times a week for about four hours each session. In peritoneal dialysis, blood is filtered inside the person’s body through a permanent abdominal tube, using a special cleaning solution. This allows the blood to be cleaned while a person sleeps or works. It can take several hours or can last overnight.

The federal government estimates that almost 400,000 people annually undergo dialysis treatment. Chronic kidney disease, especially if undetected, can progress to irreversible kidney failure, a condition known as end-stage renal disease. Patients with this condition require lifelong dialysis treatment or a kidney transplant. The two leading causes of end-stage renal disease are diabetes and hypertension.

The need for dialysis is growing in the Valley. Todd Whorton, manager of Community’s dialysis programs, said Community is seeing an annual 7% increase in patients. The number of people who need dialysis due to kidney failure is higher in the Valley than elsewhere in California. Some causes for the higher numbers may be high rates of obesity and diabetes here as well as lack of access to primary medical care. About 90% of Community’s patients receiving hemodialysis or peritoneal dialysis rely on government insurance such as Medi-Cal and Medicare.

“It’s like going in three times a week for an oil change,” Lewis said. “[Community] has fabulous staff. Especially at the outpatient dialysis unit – fabulous people.”

Lewis is surprisingly upbeat about enduring his weekly dialysis treatments. He said it’s taught him how to care for his body differently. “I learned how to treat my car well, but one of the things I realized through the process of dialysis is that I really wasn’t treating myself the same way until I started going into dialysis – learning how to do things and eat in certain ways to keep myself alive – that’s some very important stuff. I got that from my connection from those [Community] people there.”

The help that Lewis receives at Community’s outpatient dialysis center has also made a major impact in the way he now sees his medical conditions and his orientation to life. “I learned from them basically that I didn’t have to alter my life so severely that I didn’t feel like there was any quality left,” said Lewis. “They offered me a pathway and a process that if I went and continued to deal with the dialysis I would be able to feel good.”

It’s been a long road for Lewis but his determination and positive attitude are apparent in his steadfast recovery. Since having his feet amputated, Lewis has healed and undergone extensive rehabilitation, including how learning to care for and use his prosthetic feet. He progressed from a wheelchair and is now walking with the help of a walker. Next on his agenda is to get back to what he loves most – fishing.

Jennifer Avila-Allen reported this story. She can be reached at MedWatchToday@CommunityMedical.org.