LOMA LINDA >> Included in the debilitating and often deadly side effects of untreated diabetes is the costly, life-shortening condition called end-stage kidney disease.
Patients whose kidneys have lost a little more than 90 percent of their function generally require the use of a dialysis machine clean their blood of waste materials. It’s can be a three-times weekly program that can run between $1,500 and $2,000 weekly, said Dr. Sergio Infante, a nephrologist at Loma Linda University Health.
End-stage kidney disease is the last stage the ailment, when the organs can no longer remove waste and excess water from the body. Dialysis or kidney transplantation is necessary for survival, according to the United State Renal Data System.
In Southern California, the waiting list is about 10 years to get a kidney transplant, Infante said. Most patients on dialysis won’t live that long, Infante said.
Statistics show that patient mortality rises 20 percent for each year of dialysis, he said.
There are exceptions, however. Infante said he has one patient who has been on dialysis for 25 years. On the other hand, “one has been on dialysis for six months and is not going to live much longer.”
Dialysis involves people going to a facility, reclining in a lounge chair for up to about four hours, while a machine takes their blood through a tube, cleans it of waste products — as working kidneys would — and returns the blood,through another tube.
The dialysis center operated by Loma Linda University Health operates 20 hours a day, Infante said. Those four hours of the facility’s closure are to clean the equipment, he said.
Dialysis centers have been sprouting up across Southern California. The idea is to make their locations convenient to where people live, said Dr. Kevin Cordorniz, a physician in the department of endocrinology, diabetes and metabolism at Loma Linda University Health.
Most patients take their dialysis from one of two private companies specializing in that type of treatment, he said.
German-based Fresenius Medical Care, the world’s largest dialysis treatment operator, has more than 2,200 clinics across the U.S.
People are born with an abundance of kidney function, which is why healthy individuals can donate one of their two kidneys and still lead a normal life, Infante said.
But even at its early stages, diabetes can begin destroying that generous surplus capacity, he said.
Typically in the United States, patients are put on dialysis when their kidneys are functioning at between 8 percent and 10 percent of what they would if not damaged, Infante said.
“Dialysis is a huge, direct cost of diabetes,” Cordorniz said.
Medicare spending for beneficiaries ages 65 and older who have chronic kidney disease exceeded $50 billion, representing 20 percent of all Medicare spending in this age group, according to the United States Renal Data System.
The incidence of newly reported end stage renal disease was a record 120,688 cases in 2014, the most current figure available from the data system, which is the nation’s watchdog of kidney health. That was a 2.2 per cent increase from the previous year.
There were 678,383 end-stage renal disease cases in the U.S. in 2014. up 3.3 percent from the year before, according to the data system.
Hispanics are 1.5 times more likely to develop end-stage kidney disease than non-Hispanic whites, according to the Centers for Disease Control and Prevention.
Among Hispanics, the incidence rate of end-stage renal disease due to diabetes compared are similar to whites for ages 22-44 years, but much higher for ages 44 and over.
THE SYMPTOMS
According to the National Kidney Center, a private non-profit organization based in Virginia, symptoms of end-stage kidney disease, sometimes called end-stage renal failure, include:
• Anemia
• Bleeding and bruising
• Headache
• Weakness
• Difficulty breathing
• Swelling and puffiness
• Muscle cramps, muscle twitching
• Mental symptoms such as lowered mental alertness, confusion, seizures
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