Northwest Kidney Centers

Last updated

Northwest Kidney Centers
Type Non-profit organization
Industry Health care
Founded Seattle, Washington, United States (1962)
Founder Dr. Belding H. Scribner
Dr. James W. Haviland
Headquarters
Seattle, Washington
,
United States
Area served
 King County and Clallam County, Washington
Key people
Rebecca Fox (president and CEO)
Suzanne Watnick, MD (chief medical officer)
Website nwkidney.org

Northwest Kidney Centers is a regional, not-for-profit community-based provider of kidney dialysis, public health education, and research into the causes and treatments of chronic kidney disease. Established in Seattle in 1962, it was the world's first out-of-hospital dialysis provider. [1] It offers dialysis throughout the greater Seattle area in 20 free-standing clinics, eight hospitals and its home dialysis program. [2] It opened its first clinic in Everett in 2020, the organization's first in Snohomish county. [3]

Contents

Nearly 80 percent of people on dialysis in King County go to Northwest Kidney Centers for their treatment. [1] The organization's 727-member staff provided 284,511 treatments in 2019, about a quarter of all dialysis treatments in the state. [4] Northwest Kidney Centers operates the oldest home dialysis program in the United States, currently training 275 people to give themselves dialysis at home. [5]

Northwest Kidney Centers’ model of providing dialysis outside of a hospital setting has spread throughout the world. According to a United States Renal Data System 2013 report, there are 6,009 outpatient dialysis clinics in the United States. [6]

Compared to national averages, Northwest Kidney Centers patients live longer, [7] have fewer complications, [7] spend less time in the hospital [8] and receive more kidney transplants. [7]

History

Early years

In 1960, kidney failure was fatal. This changed when Dr. Belding H. Scribner of the University of Washington developed the Scribner shunt, a blood access device that made long-term dialysis possible for the first time.

Scribner turned to the King County Medical Society president, James W. Haviland, for sponsorship of a community-supported outpatient dialysis center. [9] Haviland marshaled support, drawing on his association with the University of Washington and his "clinical sense, wisdom, political acumen and knowledge" of the Seattle community to ensure that the new center operated on a not-for-profit basis. [10]

In 1962, Haviland and Scribner launched the Seattle Artificial Kidney Center, which changed its name to Northwest Kidney Center in 1970 when its services spread beyond Seattle. The name changed again, to Northwest Kidney Centers, in 1992 when there were multiple locations.

In 1964, Time magazine reported that to treat 11 patients, the Seattle Artificial Kidney Center had a staff of two full-time physicians and one half-time physician, plus five nurses and five technicians. [11] During these early years of hemodialysis, funding was extremely limited, requiring rationed access to the few available dialysis machines. A committee of physicians screened potential patients first by strict medical criteria. Patients who passed the initial medical screening were then further reviewed by an anonymous lay committee that decided who would get treatment.

In 1962, Life magazine published an article on the Seattle dialysis screening committee, which it dubbed the “Life or Death Committee.” [12] The discussion the article generated led to the development of biomedical ethics as a field of professional study. [13] In 1964, Scribner's presidential address to the American Society for Artificial Internal Organs discussed the problems of patient selection, termination of treatment, patient suicide, death with dignity, and selection for transplantation.

Early milestones

By 1964, Seattle Artificial Kidney Center had expanded to 10 stations serving 47 patients—growth that led to financial strain. In response, Scribner and his team developed home hemodialysis, training patients to treat themselves from home, reducing operational costs. [14]

In 1972, the U.S. Congress passed legislation authorizing the end-stage renal disease program of Medicare. [15] Section 299I of Public Law 92-603, on October 30, 1972, extended Medicare coverage to over 90 percent of Americans if they had permanent kidney failure and therefore required dialysis or kidney transplantation to live. [16] This funding led to wider availability of dialysis nationally and spurred the growth of Northwest Kidney Center.

In 1978, Northwest Kidney Center began offering peritoneal dialysis in addition to its hemodialysis services: first, continuous ambulatory peritoneal dialysis (CAPD) and later automated peritoneal dialysis (APD). [14]

Together with the Puget Sound Blood Center and the University of Washington Department of Orthopedics, Northwest Kidney Center jointly founded the Northwest Tissue Center in 1988. [14] Housed at the blood center, the tissue center provided human bone, tendons, skin and other tissues for transplantation.

Present work

Northwest Kidney Centers opened three new dialysis clinics in 2018, two in Federal Way and one in Fife, Washington. [17] In 2019, it opened a clinic in Rainier Beach, Wash. [18] and in 2020 it opened a clinic in Everett, Wash., [19] its first in Snohomish county.

As a nonprofit supported by financial donors, Northwest Kidney Centers is able to provide supplementary services in addition to kidney dialysis. These include special care for the most fragile patients, free health education for people at every stage of kidney disease, patient access to dental care, staff scholarships, fellowships for doctors doing advanced kidney study, and funding for research.

Northwest Kidney Centers’ full-service outpatient renal-specialty pharmacy, one of the first in the nation, [20] serves people with advancing chronic kidney disease, on dialysis, or living with a kidney transplant.

In 2008, Northwest Kidney Centers collaborated with UW Medicine in the creation of the Kidney Research Institute. Funding from Northwest Kidney Centers helps equip and maintain laboratories and pay for preliminary investigations that pave the way for larger research grants. Northwest Kidney Centers donates clinical research space in its facilities where Kidney Research Institute investigators meet with patients. [21]

In 2017, Nephrology News & Issues magazine ranked Northwest Kidney Centers as the 8th largest dialysis provider in the United States. [22]

Also in 2017, Northwest Kidney Centers announced it would provide a $15 million grant over five years to UW Medicine's new Center for Dialysis Innovation to conduct research on innovative dialysis technologies. [23]

Museum

On November 10, 2012, during its 50th anniversary year, Northwest Kidney Centers opened a museum and gallery dedicated to the history of the organization and of dialysis treatment. Located in Seattle, the museum showcases photos, artifacts, dialysis machines and equipment. [24] In 2016, the organization established a professional archive to preserve and share its history. [25]

Patient care

Northwest Kidney Centers provides 284,511 treatments a year for more than 1,833 people with kidney disease, [4] representing about 80 percent of all dialysis care in the region. [20] The organization treats patients in its 20 outpatient dialysis centers and in eight area hospitals. 275 of its patients choose home dialysis, with training and supervision from Northwest Kidney Centers. Its special care service provides additional nursing and assistance to very frail patients. [1] In 2017, Northwest Kidney Centers launched the nation's first palliative care program in a dialysis organization. [26]

Education

Northwest Kidney Centers provides free classes on issues related to kidney disease, including nutrition, types of dialysis treatment and kidney transplants. In 2017, more than half of new patients had attended a class before beginning dialysis. [27] The organization also participates in events and health fairs throughout the year, and its nutrition experts not only counsel patients on the role of nutrition in preventing and treating kidney disease, they also contribute articles to professional journals and columns to community newspapers. [1]

Research

Through its Kidney Research Institute, Northwest Kidney Centers conducts research into the early detection, prevention and treatment of kidney disease and its complications. The Kidney Research Institute has received more than $100 million in research funding, primarily from the National Institutes of Health, and published more than 1,000 scientific papers. More than 30 studies are actively underway. [27] In 2017, Northwest Kidney Centers committed to a $15 million grant over five years to jumpstart the Center for Dialysis Innovation, which works on revolutionary new technologies. [28]

Innovation

As the world's first dialysis organization, Northwest Kidney Centers created protocols and procedures that were innovative in themselves. From its establishment in 1962, the organization has been a model in the kidney care field.

Home hemodialysis

In 1964, Scribner and his team developed a machine to provide home hemodialysis for the first time. The machine, first used by Seattle Artificial Kidney Center patients, became a model for today's dialysis machines.

EPO studies

In the 1980s, Northwest Kidney Centers was the first site chosen for human studies on a synthetic form of erythropoietin (EPO), genetically engineered and later marketed as Epogen by Amgen, Inc. Dr. Joseph W. Eschbach led the trials at Northwest Kidney Centers. His results, published in The New England Journal of Medicine in 1987, showed that artificial EPO reversed anemia in kidney patients. [29] EPO hormone treatments have improved the well-being and quality of life of more than a million people with kidney disease. [30]

Wearable artificial kidney

In 2014, researchers at the Kidney Research Institute received FDA approval for the first human study in the U.S. of the Wearable Artificial Kidney. Smaller and more portable than home dialysis machines, the device is worn like a tool belt, and it administers dialysis via a catheter. [31] Northwest Kidney Centers dialysis patients are among the research trial participants.

Awards

In 2009, President and CEO Joyce F. Jackson received Washington State Board of Health's 2009 Warren Featherstone Reid Award for Excellence in Healthcare for her leadership and dedication to Northwest Kidney Centers. [32]

In 2010, Northwest Kidney Centers received the Washington State Hospital Association Community Health Leadership Award, which honors healthcare organizations that best serve their community's broad health needs. [20] The award recognized Northwest Kidney Centers’ chronic kidney disease education program, offered free to the community.

In 2013, Northwest Kidney Centers was recognized in PR Daily's Nonprofit PR Awards for 2012's best traditional marketing campaign. The award cited 50th-anniversary initiatives in public health, public policy and public education. [33]

In 2014, Seattle Magazine named CEO Joyce Jackson an Outstanding Health Care Executive as part of its annual Leaders in Healthcare Awards. [34]

In 2015, Qualis Health named Northwest Kidney Centers as the recipient of its 2015 Award of Excellence in Healthcare Quality: Outpatient Services. [35] The award recognized the nonprofit's Improving Kidney Transplantation Initiative's impact on improving health care quality and outcomes.

Related Research Articles

Nephrology Medical study concerned with the kidneys

Nephrology is a specialty of adult internal medicine and pediatric medicine that concerns the study of the kidneys, specifically normal kidney function and kidney disease, the preservation of kidney health, and the treatment of kidney disease, from diet and medication to renal replacement therapy. The word “renal” is an adjective meaning “relating to the kidneys”, and its roots are French or late Latin. Whereas according to some opinions, "renal" and "nephro" should be replaced with "kidney" in scientific writings such as "kidney medicine" or "kidney replacement therapy", other experts have advocated preserving the use of renal and nephro as appropriate including in "nephrology" and "renal replacement therapy", respectively.

Kidney dialysis Removal of nitrogenous waste and toxins from the body in place of or to augment the kidney

Kidney dialysis is the process of removing excess water, solutes, and toxins from the blood in people whose kidneys can no longer perform these functions naturally. This is referred to as renal replacement therapy. The first successful dialysis was performed in 1943.

Kidney failure Disease where the kidneys fail to adequately filter waste products from the blood

Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney failure is classified as either acute kidney failure, which develops rapidly and may resolve; and chronic kidney failure, which develops slowly and can often be irreversible. Symptoms may include leg swelling, feeling tired, vomiting, loss of appetite, and confusion. Complications of acute and chronic failure include uremia, high blood potassium, and volume overload. Complications of chronic failure also include heart disease, high blood pressure, and anemia.

Hemodialysis Medical procedure for purifying blood

Hemodialysis, also spelled haemodialysis, or simply dialysis, is a process of purifying the blood of a person whose kidneys are not working normally. This type of dialysis achieves the extracorporeal removal of waste products such as creatinine and urea and free water from the blood when the kidneys are in a state of kidney failure. Hemodialysis is one of three renal replacement therapies. An alternative method for extracorporeal separation of blood components such as plasma or cells is apheresis.

Peritoneal dialysis Type of dialysis

Peritoneal dialysis (PD) is a type of dialysis which uses the peritoneum in a person's abdomen as the membrane through which fluid and dissolved substances are exchanged with the blood. It is used to remove excess fluid, correct electrolyte problems, and remove toxins in those with kidney failure. Peritoneal dialysis has better outcomes than hemodialysis during the first couple of years. Other benefits include greater flexibility and better tolerability in those with significant heart disease.

Home hemodialysis

Home hemodialysis (HHD) is the provision of hemodialysis to purify the blood of a person whose kidneys are not working normally, in their own home. One advantage to doing dialysis at home is that it can be done more frequently and slowly, which reduces the "washed out" feeling and other symptoms caused by rapid ultrafiltration, and it can often be done at night, while the person is sleeping.

Artificial kidney is often a synonym for hemodialysis, but may also, refer to renal replacement therapies that are in use and/or in development. This article deals with bioengineered kidneys/bioartificial kidneys that are grown from renal cell lines/renal tissue.

Hemofiltration

Hemofiltration, also haemofiltration, is a renal replacement therapy which is used in the intensive care setting. It is usually used to treat acute kidney injury (AKI), but may be of benefit in multiple organ dysfunction syndrome or sepsis. During hemofiltration, a patient's blood is passed through a set of tubing via a machine to a semipermeable membrane where waste products and water are removed by convection. Replacement fluid is added and the blood is returned to the patient.

Renal replacement therapy (RRT) is therapy that replaces the normal blood-filtering function of the kidneys. It is used when the kidneys are not working well, which is called kidney failure and includes acute kidney injury and chronic kidney disease. Renal replacement therapy includes dialysis, hemofiltration, and hemodiafiltration, which are various ways of filtration of blood with or without machines. Renal replacement therapy also includes kidney transplantation, which is the ultimate form of replacement in that the old kidney is replaced by a donor kidney.

The National Kidney Foundation, Inc. (NKF) is a voluntary health organization in the United States, headquartered in New York City with over 30 local offices across the country. Its mission is to prevent kidney and urinary tract diseases, improve the health and well-being of individuals and families affected by these diseases, and increase the availability of all organs for transplantation. NKF is the largest, most comprehensive, and longstanding patient-centric organization dedicated to the awareness, prevention and treatment of kidney disease in the United States.

Belding Hibbard Scribner was an American physician and a pioneer in kidney dialysis.

Hemoperfusion or hæmoperfusion is a method of filtering the blood extracorporeally to remove a toxin. As with other extracorporeal methods, such as hemodialysis (HD), hemofiltration (HF), and hemodiafiltration (HDF), the blood travels from the patient into a machine, gets filtered, and then travels back into the patient, typically by venovenous access.

Joseph W. Eschbach

Joseph Wetherill Eschbach was an American doctor and kidney specialist whose twenty years of research starting in the 1960s led to an improvement in the treatment of anemia.

Robert Provenzano American physician

Robert Provenzano is an American nephrologist. He is also an Associate Clinical Professor of Medicine at Wayne State University School of Medicine.

The Rogosin Institute is an independent, not-for-profit treatment and research center with facilities throughout New York City that treat patients with kidney disease, including dialysis and kidney transplantation; lipid disorders; and hypertension. It is affiliated with NewYork-Presbyterian Hospital, Weill Cornell Medical College and is a leader in research programs for cancer and diabetes.

Nathan W. Levin is an American physician and founder of the Renal Research Institute, LLC., a research institute dedicated to improving the outcomes of patients with kidney disease, particularly those requiring dialysis. Levin is one of the most prominent and renowned figures in clinical nephrology as well as nephrology research. He has authored multiple book chapters and over 350 peer-reviewed publications, including articles in leading journals such as Nature, the New England Journal of Medicine, and The Lancet.

Sindh Institute of Urology & Transplantation Hospital in Sindh, Pakistan

The Sindh Institute of Urology & Transplantation (SIUT) is a dialysis & kidney transplant centre located in Pakistan. SIUT was founded by Dr. Adibul Hasan Rizvi and it is Pakistan's largest kidney disease center, as well as Pakistan's largest public sector health organisation. It began as a department of urology at the government-run Civil Hospital in 1970 and became autonomous in 1991. Ten to twelve transplants are performed weekly, and in 2003, doctors at SIUT performed Pakistan's first liver transplant. In 2004, a child care unit was opened.

Symptom targeted intervention (STI) is a clinical program being used in medical settings to help patients who struggle with symptoms of depression or anxiety or adherence to treatment plans but who are not interested in receiving outpatient mental health treatment. STI is an individualized therapeutic model and clinical program that teaches patients brief, effective ways to cope with difficult thoughts, feelings, and behaviors using evidence-based interventions. Its individualized engagement process employs techniques from solution-focused therapy, using a Rogerian, patient-centered philosophy. This engagement process ensures that even challenging, at-risk, and non-adherent patients are able to participate.

DaVita Inc. American dialysis provider

DaVita Inc. provides kidney dialysis services through a network of 2,816 outpatient dialysis centers in the United States, serving 204,200 patients, and 321 outpatient dialysis centers in 10 other countries serving 3,200 patients. The company primarily treats end-stage renal disease (ESRD), which requires patients to undergo dialysis 3 times per week for the rest of their lives unless they receive a donor kidney. The company has a 37% market share in the U.S. dialysis market. It is organized in Delaware and based in Denver.

Diaverum is a provider of renal healthcare with over 460 clinics in 24 countries, Europe, Latin America, the Middle East and Asia.

References

  1. 1 2 3 4 "Northwest Kidney Centers". Seattle Foundation. Retrieved March 27, 2015.
  2. ↑ Bruestle, Sara (March 25, 2020). "Life-saving treatments closer to home for kidney patients". Everett Herald.
  3. ↑ Journal Staff (October 8, 2020). "Northwest Kidney Centers opens clinic; expands another". Daily Journal of Commerce.
  4. 1 2 "2019 Annual Report" (PDF). Northwest Kidney Centers.
  5. ↑ "Dialysis at Home". Northwest Kidney Centers.
  6. ↑ "Annual Data Report" (PDF). United States Renal Data System. 2013. pp. 316–324. Archived from the original on June 3, 2016. Retrieved April 24, 2015.{{cite web}}: CS1 maint: unfit URL (link)
  7. 1 2 3 "2012 Annual Report" (PDF). Northwest Kidney Centers.
  8. ↑ "Community Connection" (PDF). Northwest Kidney Centers. Vol. 2, no. 1. Winter 2013.
  9. ↑ Hartwell, Lori. "From Rome to Seattle: A Short History of Dialysis". Renal Support Network. Archived from the original on June 11, 2017. Retrieved May 1, 2015.{{cite web}}: CS1 maint: unfit URL (link)
  10. ↑ "Obituary of James Haviland". The Seattle Times.
  11. ↑ "An Artificial Kidney For 15 Patients". TIME magazine. Archived from the original on April 2, 2011.
  12. ↑ Alexander, Shana (November 9, 1962). "They decide who lives, who dies: Medical miracle and a moral burden of a small committee". Life Magazine. pp. 102–25.
  13. ↑ Levine, Carol (November 30, 2009). "The Seattle 'God Committee': A Cautionary Tale". Health Affairs Blog. doi:10.1377/forefront.20091130.002998.
  14. 1 2 3 "Our History". Northwest Kidney Centers. Retrieved April 24, 2015.
  15. ↑ "Outpatient Dialysis Services Payment System" (PDF). Medpac. September 2006. Archived from the original (PDF) on July 21, 2007.
  16. ↑ "Fact Sheet: Medicare End-stage Renal Disease (ESRD) Network Organization Program" (PDF). Centers for Medicare & Medicaid Services. June 18, 2012.
  17. ↑ "Northwest Kidney Centers opens Fife dialysis clinic, its first in Pierce County". Northwest Kidney Centers (Press release). February 26, 2019. Retrieved February 26, 2019.
  18. ↑ Emerald Staff (January 8, 2020). "News Gleams: Dialysis Clinic Opens in Rainier Beach, Duran's Green New Deal Executive Order, and Snow Preparation". South Seattle Emerald.
  19. ↑ Journal Staff (October 8, 2020). "Northwest Kidney Centers opens clinic; expands another". Daily Journal of Commerce.
  20. 1 2 3 "Northwest Kidney Centers celebrates 50th anniversary". National Renal Administrators Association. January 30, 2012.
  21. ↑ "On the Horizon: Winter 2012 newsletter" (PDF). Kidney Research Institute– via Northwest Kidney Centers.
  22. ↑ Neumann, Mark (July 17, 2017). "The largest dialysis providers in 2017: More jump on integrated care bandwagon". Nephrology News & Issues. Retrieved February 13, 2018.
  23. ↑ McGrane, Clare (March 13, 2017). "UW Center for Dialysis Innovation gets $15M grant to improve dialysis technology". Geekwire. Retrieved March 13, 2017.
  24. ↑ "Northwest Kidney Centers Opens Dialysis Museum to Commemorate 50th Anniversary". Renal Business Today. November 9, 2012.
  25. ↑ "N.W. KIDNEY CENTERS SEEKS ARCHIVIST". Seattle Area Archivists. August 24, 2016. Retrieved February 13, 2018.
  26. ↑ Boerger, Emily (September 11, 2018). "Interview with Joyce Jackson, Northwest Kidney Centers". State of Reform. Retrieved September 11, 2018.
  27. 1 2 "2018 Annual Report" (PDF). Northwest Kidney Centers. October 1, 2018. Retrieved October 1, 2018.
  28. ↑ McGrane, Clare (March 13, 2017). "UW Center for Dialysis Innovation gets $15M grant to improve dialysis technology". GeekWire. Retrieved February 13, 2018.
  29. ↑ Eschbach, Joseph W.; Egrie, Joan C.; Downing, Michael R.; Browne, Jeffrey K.; Adamson, John W. (January 8, 1987). "Correction of the Anemia of End-Stage Renal Disease with Recombinant Human Erythropoietin". The New England Journal of Medicine. 316 (2): 73–78. doi:10.1056/NEJM198701083160203. PMID   3537801.
  30. ↑ "Joseph Eschbach, doctor who helped develop kidney drug, dies at 74". The Seattle Times. September 16, 2007.
  31. ↑ "Wearable Artificial Kidney gets green light for US trials". Gizmag. September 22, 2014.
  32. ↑ "Northwest Kidney Centers leader wins healthcare excellence honor" (PDF). Washington State Department of Health (Press release). November 20, 2009.
  33. ↑ "Northwest Kidney Centers uses 50th-anniversary celebration to fight epidemic". PR Daily (Press release). 2013. Retrieved April 24, 2015.
  34. ↑ Truzzi, Gianni (March 2014). "2014 Leaders in Health Care Awards: Outstanding Health Care Executive". Seattle Business. Archived from the original on March 7, 2014.
  35. ↑ "2015 Qualis Health Washington Quality Award Winners Announced". Qualis Health (Press release). May 7, 2015. Archived from the original on February 7, 2017.

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