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V.I. Dialysis Care Reaching Critical Point, Officials Say

As the territory’s population of patients with serious kidney disease keeps growing, hospitals and private clinics are working to expand kidney dialysis treatment capacity as quick as they can, public and private kidney care providers told a Senate oversight hearing Thursday.
It was not the first time testifiers from Schneider Regional Medical Center, Gov. Juan F. Luis Hospital and the private Caribbean Kidney Center have sounded the alarm about a rising tide of kidney patients throughout the territory.
As at past hearings, officials at both hospitals spoke of the need to enhance prevention programs and wellness education as a way of attacking the underlying cause of the epidemic, and of the need for money to expand the number of dialysis machines, chairs and professionals.
Juan Luis Hospital is already at its maximum capacity right now, said Dr. Ramesh Lakram, the hospital’s chairman of nephrology. Over the course of three shifts, they serve 90 patients a day, six days a week, he said. To expand, the hospital would have to go into a fourth shift, giving dialysis treatments in the middle of the night, he said.
The hospital does not have room for more dialysis chairs, but setting up a separate facility may be prohibitively expensive, so it is weighing how to expand services.
Schneider is serving about 85 patients a day and could serve up to 90, so it is not at capacity yet, said Schneider Chief Executive Officer Alice Taylor. But both hospitals expect the number of dialysis patients to double in the next five years.
Only the Caribbean Kidney Center, a private medical facility on St. Croix, has immediate plans for an expansion of dialysis services. Dr. Walter Gardiner, medical director and principal at the center, said he is well on the way to setting up a large new facility in the Frederiksted area.
"A significant percentage of patients in St. Croix are coming from the Frederiksted area, so it would make sense to have a facility in that area," Gardiner said. His existing Christiansted facility serves about 40 patients, and the new Frederiksted facility would have 20 dialysis stations and be able to serve almost 300 patients.
As a private, for-profit enterprise, the Caribbean Kidney Center does not plan to provide care that is not paid for. Gardiner said he was open to some arrangement for caring for indigent and low-income clients without insurance, but whatever agreement would need to involve some sort of reimbursement.
Both Schneider and Luis hospitals provide care without regard for ability to pay, and both their dialysis clinics lose about $1 million per year, according to their testimony to the Senate.
No bill relating to kidney care was before the committee oversight hearing. Present were Sens. Patrick Sprauve, Usie Richards, Alvin Williams and non-committee member Sen. Nereida "Nellie" O’Reilly.

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