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Interior Health working towards kidney care clinic in Nelson, but no dialysis

Lack of staffing is preventing dialysis treatment at Kootenay Lake Hospital
Kootenay Lake Hospital in Nelson, where Nelson and Kaslo councils say dialysis services should be located. Photo: Bill Metcalfe

by Rachael Lesosky

Local Journalism Initiative Reporter, Valley Voice

Interior Health is working to bring a kidney care clinic to Nelson, according to a report from BC Renal made to the West Kootenay Boundary Regional Hospital District on Jan. 24.

A kidney care clinic (KCC) does not have dialysis services. It provides education, counselling, and medical care to help slow or stop the rate of kidney decline.

“For the first time in the kidney world, we really do have ways to delay progression,” said Dr. Adeera Levin during the meeting. Levin is the executive director of RC Renal and a practising nephrologist.

Due to staffing issues across the province, setting up a community dialysis unit (CDU) for the small number of dialysis patients in the area is not sustainable. The alternative is a KCC, which can support hundreds of patients through preventative treatment – potentially helping individuals avoid dialysis altogether.

A KCC, however, does not immediately alleviate the travel burden that current dialysis patients face.

The push for a CDU began in 2018 by a group of patients living in Area D (North Kootenay Lake) and Nelson. To receive treatment, they must make the trek to Kootenay Boundary Regional Hospital in Trail multiple times per week. This is drag for anyone, but for someone with a chronic illness it is arduous.

“There is a lot of information that says that people that dialyze at home, no matter how frail they are, actually do better than people who go to a facility,” Dr. Levin told the board.

Home dialysis is gentler on patients, said Levin, and offers more flexibility and independence. It can even be performed while asleep.

“Some people are afraid of dialyzing at home, but we do provide an awful lot of support,” said Dr. Marie Michaud, renal medical director for IH and a practising nephrologist in Kelowna. “We supply all the equipment and training they need to dialyze at home, and we supervise them carefully to support them.”

Home dialysis requires about six weeks of training. Patients, their partners and caregivers – anyone – can be trained.

“Nelson is such a hands-on supportive, community,” said Michaud. “If volunteers wanted to participate in a program to support dialysis patients, we could train them to help with dialysis at home.”

Without looking at the files of the patients who are currently receiving dialysis in the area, Michaud couldn’t say for sure if home dialysis is possible for everyone.

But the WKBRHD board agreed that pursuing a volunteer support program to assist patients with home dialysis is the best option for now. The board carried a motion to send a letter to the City of Nelson outlining the proposal, and encouraging the city to work with local service organizations to recruit volunteers. A KCC can help with this too, once established.

Levin reassured the board that just because a KCC is being pursued, it doesn’t mean that establishing a CDU is completely off the table.

“Every year to six months, we re-evaluate the needs,” she said. “Just because we’re having this conversation and saying, ‘not at this time,’ doesn’t mean that it will never be. It’s just that at this time, there is no ability to support a unit.”

The board also passed a motion to send a letter to the province in support of a CDU at Kootenay Lake Hospital in Nelson.


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