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May 20, 2013 Business Strategy

Night shift dialysis changing market

Contributed Photo Patient Annie Chaney, pictured with Dr. Kory Tray, says nighttime dialysis at the Fresenius Medical Care North America in Bloomfield has changed her life for the better.
By Becky Bergman

Since kidney patient Annie Chaney started using dialysis at Fresenius Medical Care Western Hartford, she has been able to juggle family obligations, computer classes and even a part-time job as a community outreach specialist for a local church a lot easier.

The difference is simply night and day.

Three months after she joined Fresenius Medical Care's new nocturnal dialysis program, Chaney, 66, said she feels like a new person. She is happier, healthier and has more energy than she's had in years.

“Since I began dialyzing at night, I've had a lot more energy, am sleeping better and have gotten better dialysis results,” said Chaney. “I'm now able to volunteer with Easter Seals, go to church and meet up with my friends.”

Fresenius Medical Care North America is tapping a $20 billion-plus kidney dialysis business with a new concept: overnight treatment that allows patients to keep their days free for routine activities.

Kory Tray, a medical doctor at Frensenius, says the new service allows patients to receive treatments in the company's Bloomfield facility overnight, while sleeping or resting.

“Nighttime dialysis offers the same level of supervised care as traditional daytime treatments, but is typically administered for a longer period of time overnight, allowing patients to keep their days free for work, family or other activities,” said Tray.

Dialysis is a life-sustaining process that cleans waste products from the blood and removes extra fluids when a person's kidneys fail. Patients generally require treatment on an ongoing basis unless they receive a transplant, said Tray.

The company, which is based in Waltham, Mass., has more than 140 nighttime dialysis programs providing care around the country. The company operates a network of more than 2,100 dialysis facilities in the U.S.

For the 4,000 Connecticut residents with kidney failure who require dialysis or a kidney transplant to live, the new concept gives patients in the Greater Hartford region more options.

Fresenius is the only medical provider to offer overnight dialysis in Connecticut. It has 16 beds with room to expand to 32.

On average, patients typically spend 12 to 18 hours a week, during the day, receiving dialysis treatments. Treatment usually last three to four hours each, making it difficult for patients to have full-time jobs, extracurricular activities and fun hobbies, said Tray.

In nighttime dialysis, patients typically receive treatments three times a week, but for about eight hours at a time. Because fluids are removed from the body over a slower process, the treatment is easier for patients to tolerate, said Tray. With nocturnal dialysis, patients also experience improved lab results, a decrease in medication usage and overall improvement of feelings of well-being.

Studies also suggest that nighttime dialysis patients may be able to better control their blood pressure and mineral levels, resulting in fewer dietary restrictions, which allows them to eat a wider variety of foods, according to Tray.

Chaney says her overall health has improved. The shorter, daytime treatments left her feeling exhausted, dizzy and nauseous. Many times after daytime treatment, she could barely make it home to sleep.

At the Fresenius center in Bloomfield, patients start arriving around 9 every Sunday, Tuesday and Thursday evening. The nursing staff does a check for blood pressure, body weight and heart rate, and inputs the information and other patient data into the large dialysis machines, which act as external kidneys.

“Now I go in at 9 at night and rest while I get my treatment,” said Chaney. “I'm usually done by 6 in the morning. I go home, take a shower and have breakfast before I go to school. I feel like a normal person again.”

The National Kidney Foundation estimates that more 368,000 Americans rely on dialysis to survive.

The organization does not track numbers for patients who opt for nocturnal dialysis. The estimated annual cost of serving dialysis runs about $77,000 per patient, with 100,000 more clients added annually.

While there is space available for new patients, Tray says it costs more to operate an eight-hour overnight period compared to the daytime. And it's a challenge to find nurses willing to work the overnight shift.

The new overnight dialysis program at Fresenius has garnered praise from local doctors and industry experts who say there is a need for the service.

Competitor DaVita Inc. operates more than 30 dialysis centers in Connecticut, but none with a nocturnal program. The firm has nearly 2,000 dialysis clinics across the U.S.

“In Connecticut, we haven't seen the strong patient interest necessary to support nocturnal programs,” said David Tauchen, a spokesperson for DaVita. “Of course, if there were to be a surge of interest, we'd reevaluate.”

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