Dialysis shortage creates expensive problem for city

Dialysis centers in The City increasingly exceed capacity, requiring some patients to be hospitalized for days or weeks — often on the public dime — while they wait for a spot at an outpatient clinic to receive the life-saving treatment.

Dialysis is a blood-filtration technique used on patients who face kidney failure. Because more than 100,000 Americans currently need kidney transplants, the wait for a donated organ can take years. In the meantime, patients are treated with dialysis to keep them alive. The typical treatment requires a patient to sit in a clinic for about three hours, three times a week, while their blood is filtered by a machine.

Diabetes is the leading cause of kidney failure, accounting for nearly 44 percent of new cases.

San Francisco General Hospital contains The City’s only public dialysis clinic, but it has just 13 beds. It has never expanded because it “really can’t squeeze another chair in,” said Dr. Sam James, medical director of the clinic.

Since the 1970s, each of the clinic’s 13 chairs takes three shifts of dialysis patients. But in recent months, the capacity problem has become so bad that the nursing staff has had to extend the hours of the clinic three days a week to take a fourth patient, and now it’s asking for funding to expand the hours for three more days a week.

When patients need dialysis but there’s no room in the outpatient center, they can end up being hospitalized. Hospitalizing a patient for dialysis can cost taxpayers thousands of dollars a day, whereas receiving the three-hour blood-cleansing treatment costs just hundreds of dollars, according to hospital officials.

According to General Hospital Chief Operating Officer Roland Pickens, about 20 people were hospitalized there for dialysis in April and 16 in May. Last week, there were seven people hospitalized for dialysis, but as of Monday, that figure was down to two.

Counted among those two was patient Ruth Nemesio, who was hospitalized two weeks ago and is waiting for a seat at an outpatient clinic. One chair had opened up at a clinic, but it was in Chinatown, an impossible trek to make three times a week from her home near The City’s southern border because Nemesio is nearly blind.

“If they know there’s a lot of people with kidney failure, they should think about [an increased demand for capacity],” she said. “That always happens. They wait to fix something until it’s too late. Just like when we have earthquakes or floods.”



Centers see demand increase

The overflow at dialysis centers in The City has been growing worse as the recession wears on and people lose their insurance, landing them at the publicly run San Francisco General Hospital, according to officials.

Stoking the overcrowding problem was the temporary shutdown of a dialysis center in Daly City that required patients to be transferred to facilities in San Francisco. Also, Kaiser Permanente temporarily shifted patients from one of its area outpatient dialysis units during repair work on the site, hospital spokesman Joe Fragola said.

The extra patients in the region mean there is now a waiting list at the for-profit dialysis centers, and because patients need dialysis while they wait for a seat to open, they are hospitalized, said Dr. Sam James, medical director of the dialysis clinic at General Hospital.

“It’s sort of come to a bit of a head now because we’ve never had so many patients,” James said.

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