The Clinic of the Future — Your Own Home

As medical equipment becomes smaller and easier to use, we at Fresenius Medical Care are ready to make life a lot better for our kidney patients.

When the doctor discovered not one but two tumors on his kidney, Anvil Nelson Jr.’s response came unexpectedly: “I guess they have my kidney surrounded.”, he said laughing, “Let’s get it out of there quick”.

I admire someone so brave. As the leading provider of kidney care in the country, our teams at Fresenius Medical Care talk to patients every day, but Mr. Nelson seems an outstanding case. He had already lost a kidney – and only a few decades ago, losing the other would have been a death sentence. Fortunately, it no longer is: Today, hundreds of thousands of Americans can survive the loss of their kidneys, because their function is replaced by dialysis.

However, the machines that save their lives often take over their lives: Most patients need to visit a dialysis clinic three times a week for a treatment that lasts several hours. That’s why I thought of patients like Mr. Nelson a few weeks ago, when President Trump signed an Executive Order to improve medical care for the millions of Americans suffering from kidney disease. “This is a dramatic and long overdue reform,” the president commented, and experts like Mark E. Rosenberg, president of the American Society of Nephrology, were quick to concur: “I have been a kidney doctor for 35 years, and this is the most game-changing thing ever to happen.”

As the CEO of Fresenius Medical Care I am happy our patients now receive attention at the highest level. This is why I want to use this opportunity to showcase the efforts we are taking to improve our patients’ quality of life. I have already discussed our industry-leading approach to care in an earlier post – now I would like to talk about a development in technology, that can make life for our patients so much better.

Today, most of us have a phone in our pocket that is more powerful than the computers that put us on the moon. Fresenius Medical Care has always been a technology leader, so we soon realized what this development could mean for our patients: Smaller, more user-friendly dialysis devices allow us to treat people at their homes or wherever they want to be treated. For years, our patients had been telling us how important it is for them to work and stay active. Portable hemodialysis systems could be a safe and highly effective way to deliver on that promise. So we invested 2 billion dollars to acquire NxStage, a company that makes one of the best home dialysis systems available today. And here’s where Mr. Nelson comes back into the story: He is among the first generation of patients using NxStage – and it has been life-changing for him.

Mr. Nelson started his dialysis treatment at a center, but according to him he never really had time for it: “Between family, business and my volunteer commitments, my life is quite busy”, he says. Mr. Nelson lives in Nashville, Tennessee and has a company in Chattanooga, which means a two and a half hours commute at least twice a week. He also officiates High School track meets and is very active in his church and the Kidney Community. “Dialysis will prolong my life, so I was optimistic and curious about it”, he remembers, “but you can’t come in half an hour late, or you’ll wreak havoc on everybody else’s timing.” That’s why he started going to the center at 5 in the morning, hoping he could get work done later in the day.

Maintaining an active lifestyle is not easy when you are on dialysis. Mr. Nelson remembers how he almost missed Thanksgiving with the family – the dinner was at his brother’s house, six and a half hours away in Illinois, and he had to be back to Nashville for his 5 am session. He also remembers how tired he often felt after his treatments, which can happen if you are only on dialysis three times a week. Here comes another NxStage benefit: You can stay on your machine longer or more frequently, even at night, which is more similar to your kidney’s natural function and will help you feel better and more energetic. “Now that I have my machine, I can take it with me”, Mr. Nelson says, “I can do it at home or in a hotel room or wherever I want, make my own schedule, set the room temperature the way I like it and watch TV with my family. And even if I do dialysis and work a full day, which I do almost every day, I don’t feel washed out anymore.” 

Today, only about 12 percent of U.S.-Americans with end-stage renal disease get dialysis at home. “For me, it’s a blessing”, Mr. Nelson says, “I couldn’t do what I do if I didn’t have an NxStage machine.” He is not alone in his opinion: 82% of our U.S. patients would prefer to be treated at home. This administration has laid out the ambitious goal of shifting 80% of current dialysis patients to either home care or a transplant by the end of the next decade. Given the shortage of available kidneys (which encouraging new donors will hopefully alleviate but likely not solve), we expect home dialysis to play an increasingly important role in the care we provide in the years to come.

Home dialysis may not be possible for every patient, as some are coping with other health conditions or lack the support they need to take advantage of the treatment. Still, I strongly believe NxStage will make a great difference for many of our patients, especially when combined with our industry-leading approach to care. The NxStage machine is so easy to use, that Mr. Nelson finds it empowering: “I attach myself to the machine”, he says, “some people say they are scared of needles, but I wouldn’t trust anybody more than myself. From then on, all I really have to do is check my blood pressure every 30 minutes and punch those numbers into the iPad attached to machine, which gives me time to work on my computer, talk to my family, read a book and pet my dog.”

Should an issue arise, Mr. Nelson can always call on his team, which he is connected to via our remote patient monitoring: “It’s only once a month that I go to a clinic and see a doctor, a nurse, a dietician and a social worker – and they treat me so well when I go in there that I call them ‘my team’. Once this lady walked up to me and asked ‘Is there anything I can do to help?’. It was only later that I found out she was the Regional Vice President for Fresenius Medical Care. That attitude from the top spreads throughout the team – they will do anything to help.” Fresenius Medical Care has been building the clinic of the future for the past thirty years. What Anvil Jr. didn’t know was that it was to be based in his own home.