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Merrimack Valley

Methuen dialysis clinic makes history caring for patients overnight

By Jill Harmacinski
Staff Writer
Published: February 13, 2008

METHUEN — Last month, a police officer working the overnight shift noticed something odd in a medical office on Merrimack Street: The lights were on all night.

"The officer came right in and said, 'What's going on here?'" recalled clinical nurse manager Sheila Jette.

A Fresenius Medical Care office at 421 Merrimack St. quietly made history recently when it became the first dialysis clinic in the state to care for patients overnight. Patients can sleep at the clinic while a dialysis machine does what their kidneys can no longer do — remove toxins and waste from their blood.

The eight-hour overnight treatment differs from intensive three- to four-hour daytime sessions because it's more gradual, gentle and closely mimics normal kidney function. As a result, the nighttime dialysis patients find themselves having more energy, better sleep and improved appetites. And it's covered by most insurance companies.

Jette said many dialysis patients are willing to give up their own beds for the overnight treatment.

"Especially once they realize this is the reason they are feeling better," said Jette.

Elaine, a patient who lives in Methuen, started the overnight treatments in December. She's spent the past one and a half years on dialysis and said the overnight schedule blends better with her work schedule in the tax industry. Her sister drops her off at night for dialysis, which works great with her schedule.

While she hasn't noticed a dramatic improvement in her health, others in the nighttime program have.

"One gentleman I see here at night told me he feels like he has more energy than before he got sick," she said.

The difference between daytime and nighttime dialysis treatments is like driving a "Volkswagen on a dirt road or a Rolls Royce on a freshly paved highway," according to a doctor's report posted on the American Association of Kidney Patients Web site.

Nighttime dialysis treatments were first introduced in the 1990s in Canada as a home-based, cost-saving measure. The first programs were so successful, Fresenius started the nighttime care at its clinics, according to the American Association of Kidney Patients.

The treatments do require patients to juggle traditional nighttime routines, including finding help caring for relatives, children and pets when they're away from home. But the treatments are often a nice fit for dialysis patients who work a 3 to 11 p.m. schedule because they can come in right after work, Jette said.

"Many patients are willing to give up their own beds at night a few times per week because they know these treatments are going to help them be more productive during the day," said Jette.

Dialysis treatment is for patients who have end-stage renal diseases which affects kidney function. Machines throughout the 10,000-square-foot unit do the work of kidneys and today, thanks to great strides in kidney research and medical technology, keep patients healthy for decades longer than ever before, Jette said.

Fresenius in Methuen treats all types of dialysis patients, from those recently diagnosed with renal disease to folks who've undergone unsuccessful kidney transplants. Patients are referred to the clinic by nephrologists and other physicians, Jette said.

The first step through the clinic door is hardly an easy one for any dialysis patient.

"This is a big pill for them to swallow," she said. "But we give the best treatment we can at whatever stage they're at."

The overnight treatments started in October with just a handful of patients. Twenty beds are available and "we are looking to grow the program," Jette said.

The nighttime treatments are offered on Monday, Wednesday and Friday. Internet, television access and round-the-clock security is offered to patients at every dialysis site in the unit, Jette said.

Fresenius, the nation's largest network of dialysis clinics, also offers home-care treatments to dialysis patients.

What is dialysis?

r Dialysis replaces the work of healthy kidneys. The process is necessary when a patient's own kidneys can no longer take care of the body's needs.

r Like a healthy kidney, dialysis keeps the body in balance by preventing waste, salt and extra water from building up in the body. Dialysis also maintains safe levels of potassium, sodium and bicarbonate in the blood. It also helps control blood pressure.

r Kidney failure is not always permanent. In some acute cases, the kidneys get better after a short time on dialysis. Other end-stage kidney disease patients need dialysis for the the rest of their lives or until they undergo a transplant.

r Many patients undergo daytime dialysis treatments, three times per week for about four hours. But patients who receive overnight treatments report more energy, better sleep and good appetites afterward.

*Sources: American Association of Kidney Patients and National Kidney Foundation.

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