Fri, Feb 18, 2022 at 02:25 PM

Dialysis now available to hospitalized patients at Marshall Medical Centers

Marshall Medical South’s new dialysis service is answering a need for patients with kidney failure.

Marshall Medical South’s new dialysis service is answering a need for patients with kidney failure. The hospital’s new portable equipment makes it possible to perform dialysis in a patient’s room rather than having to transfer them to another hospital.

“There was absolutely a need,” said Dialysis Nurse Manager Jonathan Lynn. The new department has performed more than 150 treatments from its beginning in mid-August until the end of the year.  

Previously, when a patient in kidney or renal failure came to the hospital, he or she would have to be transferred to another facility that could provide dialysis services. Accident victims with kidney injuries or surgery patients had to be moved, and it is often difficult to find an open bed.  

The program officially began during the height of the second COVID-19 surge.  The timing worked well as patient transfers to other hospitals were near to impossible.  Many COVID patients in ICU required dialysis that could now be performed in the hospital. When the service began, it was used to treat COVID-19 patients because beds at other hospitals offering dialysis were hard to come by.   Once that demand decreased, dialysis was available for any patient admitted to the hospital. Patients at Marshall North needing dialysis can be transferred to Marshall South.

“We were very fortunate to find Jonathan Lynn when we were searching for an inpatient dialysis manager,” said Chief Nursing Officer Kathy Woodruff. “He grew this program from the ground up and is the reason our program has been successful. I am so thankful that we are able to offer inpatient dialysis to our community at Marshall Medical Center South.”

An additional need for dialysis in a hospital setting is Continuous Renal Replacement Therapy or CRRT. Unlike traditional dialysis, which takes three to four hours, continuous dialysis runs 24 hours a day and is used for ICU patients with acute kidney failure because it is gentler on the body.  In the future, Marshall Medical plans to offer a version of CRRT called SLED, Slow (or Sustained) Low Efficiency Dialysis.

Marshall Medical purchased three hemodialysis systems at a cost of approximately $50,000 each. With hemodialysis, a patient’s blood is circulated outside the body using a machine to pass the blood through a dialyzer or artificial kidney. The system does a thorough cleaning job by running a patient’s entire volume of blood through the machine several times.

“The beauty of the machine is that it’s all in one,” Lynn said. “You don’t have to drag multiple pieces of equipment all over the hospital.” 

The machines, called Tablo, are mobile, self-contained, consoles comprising a water purification system and a dialysis delivery system that uses a dialyzer. In addition to cleaning the blood, the system can remove excess wastes and fluid when the patient's kidneys can no longer perform that task. Dialyzers are made of a thin, fibrous material.

Developed by Outset Medical for the treatment of patients with acute and/or chronic renal failure, Tablo is the first such system to receive approval from the FDA for use in patients at their home. According to the company’s website, the Tablo system is an all-in-one machine that's easy to learn, easy to use, connected and intelligent. Other features include:

• automated self-cleaning
• a blood flow rate of the system up to 400ml per minute, which is very fast
• integrated blood pressure cuff
• training time for operators is only a few hours

More than 500,000 people in the US currently need dialysis treatment three or more times a week, which takes about four hours per treatment. Every year, approximately 100,000 new patients start taking dialysis treatment.

Lynn is grateful that patients can get dialysis services in the hospital and he’s happy to be a part of it.

“I count it an honor to have been a part of making history on August 13, 2021, when inpatient hemodialysis was offered for the first time in Marshall County at Marshall Medical Center South.”

His co-worker, Jamie Coffen, dialysis RN, also appreciates the opportunity to work in the new department.

“I am honored to be a part of the new Dialysis Unit at MMCS,” she said. “Being a dialysis nurse is beyond rewarding. Having acute hospital dialysis available to critically ill patients will optimize their treatment.”