A pair of firms attempt to respond to the expanded need for renal care
The two companies providing outpatient and acute dialysis services in Hawaii are expanding facilities to try to meet growing needs of residents with kidney disease.
Fresenius Medical Care is providing dialysis services at Castle Medical Center, Kapiolani Medical Center at Pali Momi, Straub Clinic & Hospital and Wahiawa General Hospital, said Jane Idica, manager for the western Honolulu area. At Pali Momi, she said, "we've got twice the load that we normally do."
Staff from the outpatient facilities had to be diverted to help with hospital services a couple of times in an "emergency crisis mode," she said.
She said mandatory overtime is being enforced, and per diem and travel nurses have been hired to help.
"We're going crazy," she said. "Even our own acute manager, who is supposed to manage staffing, is going out to do treatments."
Fresenius has nine outpatient centers on Oahu, normally with three daily shifts of patients for dialysis, Idica said. Two have 48 dialysis chairs each, and other facilities have 24 each, she said.
Liberty Dialysis Hawaii LLC, which took over former St. Francis Medical Center's outpatient renal dialysis program in 2005, has 14 clinics on five islands, each with a different capacity, and they are adding shifts, said Jane Gibbons, executive vice president.
The Kaimuki clinic is being expanded, and new ones are being built in Waipahu and Kailua, she said.
Hawaii has one of the highest rates of kidney disease in the nation, and cases are continuing to increase, primarily associated with diabetes, said Glen Hayashida, National Kidney Foundation of Hawaii chief executive officer.
He said 156,000 islanders have one of five stages of chronic kidney disease, and another 100,000 are at risk, with no signs or symptoms. About 2,300 people statewide have renal or kidney failure and need dialysis or a transplant to sustain life, he said.
The last report from the Transpacific Renal Network, in 2002, showed Hawaii had an end-stage renal disease prevalence rate at 1,501 per million population -- higher than the national average of nearly 1,040 per million. Although the figures are 6 years old, nothing has gone down, Hayashida said.
Nearly 60 percent of renal dialysis cases were attributed to diabetes. There were 332 deaths among patients on dialysis in 2002, and 207 had a primary diagnosis of diabetes.