BALTIMORE — For the first time in the 50-year history of the Medicare End-Stage Renal Disease Program, there's been a decline in patients on dialysis. And it's not because of medical breakthroughs.
It's due to higher mortality rates from COVID-19, which has caused serious illness and shortages impacting access to life-sustaining treatments, according to the National Kidney Foundation.
Makeda Garvey needs dialysis to survive.
“I treat for four hours a session, three days a week,” said Garvey.
She’s received dialysis treatments for the last five years, most recently at a DaVita Dialysis Center in Maryland. She knows her treatments well and noticed something was off several weeks ago.
“I noticed that the number, it’s supposed to be 800 had been reduced to 500 and I thought the tech had just made a mistake,” Garvey said.
Her dialysate flow rate had changed, but she didn't know why.
“So the very next treatment, the facility administrator came over to me and said, ‘There’s a shortage, we’re having to ration,’” said Garvey. “And in my mind, the first thing they should’ve done when they reduced our treatments was give us, first of all, tell us. You have to inform us.”
DaVita later issued a letter to patients notifying them of manufacturing and shipping disruptions impacting 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 that we can continue to treat patients safely,” according to the statement.
“If you’re talking about reducing treatment times or treatment strengths, it can affect us very, very adversely. Those machines keeps us alive and without them, we die,” said Garvey.
“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 American Society of Nephrology issued a letter calling on federal, state, and local governments to take immediate action to ensure dialysis facilities have access to needed supplies and staff.
“We feel that there’s been a lack of emphasis on the dialysis population, on the needs of the dialysis population,” said Dr. Palevsky.
Fresenius Medical Care, a supplier of dialysis care products and treatment provider, said staffing absences and transportation interruptions led to this shortage.
They've pulled in National Guard members to supplement their workforce, accelerated local hiring efforts, and are redistributing employees. Click here to read their full statement.
A DaVita spokesperson wrote:
“Given the urgency of the situation, patients’ physicians temporarily adjusted prescriptions as we concurrently notified patients—both in person and in writing. These adjustments ordered by our patients’ physicians are backed by research and proven safe and effective.”
The National Kidney Foundation said treatments can safely be adjusted if patients are closely monitored.
“I would consider this approach as contingency management to avoid needing to go to crisis management,” wrote Dr. Pavlesky.
“The most important thing for me is dialysis patients start to pay attention, ask 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 it if there’s another variant? So to kind of be on edge all the time not knowing how or if it’s going to return to normal is a difficult thing,” said Garvey.
A Fresenius spokesman told WMAR-2 News Mallory Sofastaii that he anticipates these supply and staffing shortages to improve within the next few weeks.
However, the National Kidney Foundation is still concerned that more hasn't been done and sooner to protect this vulnerable population from the impacts of COVID-19.
If you are concerned about the care you’ve been receiving, you can file a complaint with the Centers for Medicare and Medicaid Services.
In Maryland, there is also a Commission on Kidney Disease that certifies dialysis and treatment centers, helps resolve complaints, and sets standards for the practice of chronic dialysis and transplantation. Click here to file a complaint with The Commission.