BALTIMORE — For the first time in the 50-year history of Medicare’s end-stage kidney disease program, there has been a drop in the number of patients on dialysis. And it’s not because of medical breakthroughs.
According to the National Kidney Foundation, this is due to higher death rates from COVID-19, which has caused serious illnesses and shortages affecting access to life-saving treatments.
Makeda Garvey needs dialysis to survive.
“I treat four hours per session, three days a week,” Garvey said.
She has received dialysis treatments for the past five years, most recently at a DaVita dialysis center in Maryland. She is knowledgeable about her treatments and noticed something was wrong several weeks ago.
“I noticed the number, which was supposed to be 800, had been reduced to 500 and thought the tech had just made a mistake,” Garvey said.
Her dialysate flow had changed, but she didn’t know why.
“So right from the next treatment, the administrator of the facility came up to me and said, ‘There’s a shortage, we have to ration,'” Garvey said. “And in my mind, the first thing they should have done when they cut our salaries was to give us, first, to tell us. You must inform us.
DaVita then sent a letter to patients informing them of the manufacturing and shipping disruptions affecting all dialysis providers and causing a shortage of certain supplies needed to perform dialysis.
“We are putting policies in place to help conserve the supplies we have so we can continue to treat patients safely,” the statement said.
“If you talk about reducing treatment times or the strength of treatments, that can affect us very, very negatively. These machines keep us alive and without them we die,” Garvey said.
“We are very concerned about this,” said Dr. Paul Palevsky, professor of medicine at the University of Pittsburgh and president of the National Kidney Foundation.
Last month, the National Kidney Foundation and the American Society of Nephrology released a letter calling on federal, state and local governments to take immediate action to ensure dialysis facilities have access to needed supplies and personnel.
“We feel there has been a lack of emphasis on the population on dialysis, on the needs of the population on dialysis,” Dr. Palevsky said.
Fresenius Medical Care, a supplier of dialysis and treatment products, said staff absences and transport disruptions led to the shortage.
They recruited members of the National Guard to supplement their workforce, accelerated local hiring efforts, and redistributed employees. Click here to read their full statement.
A DaVita spokesperson wrote:
“Given the urgency of the situation, the patients’ physicians have temporarily adjusted the prescriptions while we simultaneously notify the patients, in person and in writing. These adjustments ordered by our patients’ doctors are backed by research and proven to be safe and effective.
The National Kidney Foundation said treatments can be adjusted safely if patients are closely monitored.
“I would view this approach as emergency management to avoid having to resort to crisis management,” Dr. Pavlesky wrote.
“The most important thing for me is that dialysis patients start paying attention, asking questions,” Garvey.
She knows she can’t control the supply chain, but she can demand full transparency and action.
“Is it a month, is it two months, is it six months? Is there another variant? So to be kind of nervous all the time not knowing how or if it’s going to go back to normal is a tough thing,” Garvey said.
A spokesperson for Fresenius told WMAR-2 News Mallory Sofastaii that he expects these supply and personnel shortages to improve in the coming weeks.
However, the National Kidney Foundation remains concerned that more has been done sooner to protect this vulnerable population from the impacts of COVID-19.
If you are concerned about the care you received, you can file a complaint with the Centers for Medicare and Medicaid Services.
In Maryland, there is also a Kidney Disease Commission that certifies dialysis and treatment centers, helps resolve complaints, and sets standards for chronic dialysis and transplant practice. Click here to file a complaint with the Commission.