Dialysis providers and patients grapple with supply shortage

Dialysis patients across the country are feeling the effects of shortages of blood cleaning solutions, including in South Dakota.

Patients diagnosed with kidney disease must undergo treatment three times a week to filter their blood. The blood is filtered through a dialysis machine which contains an acid bicarbonate solution. Dialysis works on behalf of the kidneys to balance acid and water levels.

“The kidneys also help regulate electrolyte balances. That’s why we put the acid concentrate and the acid [bicarbonates] in the solution so we can keep tabs on electrolytes, potassium and calcium.

This is Mike Thompson, the director of dialysis at Monument Health in Rapid City. He says the health system was aware of the shortage in December and created a plan to conserve resources. Monument Health decreases the dialysis flow rate, which is the amount of dialysis solution. The acid bicarbonate solution is reduced from about 700 milliliters per minute to 600 for most patients.

“The reason they did this is that our medical director said there was very little impact at this reduced level, so it will save us quite a bit and we are comfortable with that,” he said. Thompson said.

About 175 dialysis patients in Rapid City and Spearfish received letters from Monument Health informing them of the decrease in the flow of their treatment. The decline began last month.

Fresenius is the larger of the two suppliers of acid bicarbonate solutions in the United States. In a statement released in January, the company said it was experiencing a severe labor shortage. Workers cannot keep pace with manufacturing and transporting supplies.

Taya Swanson manages supply chain procurement at Avera Health in Sioux Falls. His team identified shipping changes earlier and created plans to conserve acid soda supplies.

“We also worked closely with our primary supplier to help us understand what our allocations from them would be, and then we also worked with a secondary supplier,” Swanson said.

Junaid Syed is a nephrologist at Avera Health. He said the dialysis treatment at Avera has not changed. The health system serves more than 700 dialysis patients.

Maria Regnier, senior director of dialysis services at Sanford Health in Sioux Falls, said Sanford recently reduced flow rates.

“There are a few patients that we’re going to have to leave at higher flow rates just because of the size of those patients and they produce more waste, so we have to leave them higher,” Regnier said. “So it’s very individualized what we’re trying to do.”

Sanford treats approximately 600 dialysis patients.

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