Dialysis provider shuts five centers in D.C. area

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The nation's largest kidney-care provider has closed five dialysis centers in the greater Washington area, which has one of the highest rates of kidney disease in the country.

In addition, the dialysis provider -- Fresenius Medical Care North America -- says more closures can be expected because of a lack of reliable government funding.

"When the patients are on Medicare and Medicaid, we can't survive," company Vice President Robert Ward said. "We're losing money every treatment."

Fresenius Medical, based in Lexington, Mass., has closed one dialysis center in Prince George's County, two in the District and two in the Baltimore area. The closures affect about 5,000 local patients who have end-stage renal disease and rely on dialysis to survive.

Of the nearly 20 million kidney patients nationwide, more than 375,000 live between Baltimore and Fredericksburg, Va., according to the National Kidney Foundation of the National Capital Area.

"Based on our population, we're right at the top," said Dr. Andy Howard, a former kidney foundation chairman.

Mr. Ward said the number of kidney patients in the region has more than doubled since 1990 and is expected to rise further.

Health care providers said dialysis centers are closing because Medicare reimburse-ments have not kept pace with the increase in kidney patients and treatment costs over the past two decades.

"The funding [for dialysis] comes straight out of Medicare," said Nancy J. Sharp, a registered nurse with the American College of Nurse Practitioners.

"Medicare pays approximately $130 [per treatment]. It hasn't raised from that since about 1983. The rest of the world keeps getting more money from inflation, but the dialysis rate has just kept the same."