BOUNTIFUL -- Bountiful Dialysis patients are doing better than ever, but it's still not quite good enough, Program Manager Jerry Bell said at a recent open house. Delegates from Representative Rob Bishop's and Senator Bob Bennett's offices joined Utah Department of Health Executive Director David Sundwall and several nurses and physicians as they discussed the problems associated with dialysis. There simply isn't enough money to deal with all of the patients, especially the home care people. And Medicare simply can't offer enough reimbursement for physicians, nurses and dialysis patients, Bell said.

Dialysis is a method of dealing with kidney failure. Patients are usually hooked up to a machine at least three times per week for four-hour treatments. During this process, the patient's blood goes through a tube to the dialysis machine and dialyzer, which filters blood much like a kidney would before putting it back into the body.

A dialyzer is an artificial kidney, the filter that cleans the blood of patients. It is used many times, and cleaned after each use.

Caregivers are careful when administering treatments. Even regular drinking water isn't clean enough for the work they do, said Nazia Junejo, a nephrologist and medical director at Bountiful Dialysis. The center has an on-site purification system that cleans fluoride, pesticides, and metals like aluminum and copper out of the water used during dialysis.

But these treatments are time consuming and must be done on a rigid schedule, which makes working almost impossible. And patients are sometimes drained of energy when they leave.

Junejo said patients are moving more toward home dialysis, where a caregiver -- usually a family member -- is trained on the machine and helps the patient to do treatments at home.

"Patients have to have some liberty and independence in order to retain their employment and their lifestyle," she said. In home dialysis, patients can get more than the usual three treatments per week, which is traditionally better for their health. And they can also do longer, eight-hour "nocturnal" sessions that they sleep through during the night.

But while home dialysis provides much more freedom for patients, it is only a temporary step for those who are waiting for a kidney replacement, she said. If they don't get their kidney donation, they have to go back to the dialysis center.

According to Junejo, the number of people needing dialysis is on the rise, with kidney disease expected to double by 2010.

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