The Northwest Kidney Centers in Seattle Washington was established in 1962 as the first out-of-hospital outpatient hemodialysis treatment center. The model of providing hemodialysis outside of a hospital setting has spread throughout the world. On December 31, 2007, in the United States, over 368,000 people receive hemodialysis through over 5,300 outpatient dialysis facilities.[1]
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The Northwest Kidney Centers (NKC) is a not-for-profit community based organization whose mission is: "to promote the optimal health, quality of life and independence of people with kidney disease, through patient care, education, and research." NKC partners with the Northwest Kidney Centers Foundation (formerly known as Northwest Kidney Foundation) to raise support to advance this mission.
In 1960 chronic kidney disease was a fatal disease. Dr. Belding H. Scribner of the University of Washington developed the Scribner shunt, a blood access device which made long-term maintenance hemodialysis (treatment for stage 5 chronic kidney disease) possible for the first time.[2] Dr. Scribner turned to the King County, Washington Medical Society President James W. Haviland for sponsorship of a community supported outpatient dialysis center.[3] Dr. Haviland marshaled community support, drawing on his association with the University of Washington, and according to colleagues his "clinical sense, wisdom, political acumen and knowledge" of the Seattle community to ensure that the new center operated on a not-for-profit basis.[4]
The organization was launched in 1962 and was initially called the Seattle Artificial Kidney Center, until the reach of their services lead them to change their name to the Northwest Kidney Centers in 1970. In 1964 Time magazine reported that to treat eleven patients, the Seattle Artificial Kidney Center had a staff of two full time physicians and one halftime physician, plus five nurses and five technicians.[5] During these early years of hemodialysis, funding was extremely limited, which limited the access to treatment. Rigid patient selection was needed for the few available dialysis machines. A committee of physicians screened potential patients first by strict medical criteria. Patients who passed the initial medical screening were then further reviewed by an anonymous lay committee which decided who would get treatment.
In 1962 Life magazine[6] published an article on the Seattle hemodialysis screening committee which Life magazine dubbed the "Life or Death Committee". The need to ration the life saving treatment led to the development of biomedical ethics. In 1964, Dr. Belding H. Scribner's presidential address to the American Society for Artificial Internal Organs discussed the problems of patient selection, termination of treatment, patient suicide, death with dignity, and selection for transplantation. In 1964 the Seattle Artificial Kidney Center under the guidance of Dr. Joseph W. Eschbach launched one of the world's first Home hemodialysis programs.[7]
In 1972 the US Congress passed legislation authorizing the end-stage renal disease (ESRD) program of Medicare. Section 299I of Public Law 92-603, on October 30, 1972, extended Medicare coverage to over 90 percent of Americans if they had permanent kidney failure and required dialysis or kidney transplantation to live. This funding led to the wider availability of dialysis nationally and spurred the growth of NKC.
In 2009 NKC operates with a staff of 525 providing over 200,000 outpatient and home dialysis treatments a year through fourteen centers and inpatient dialysis in regional hospitals.
Locations
NKC's largest facility, the Seattle Kidney Center on First Hill, Seattle, Washington offers outpatient dialysis, Home Hemodialysis, Peritoneal dialysis and a renal pharmacy. Also on First Hill is the Elliott Bay Kidney Center and the Broadway Kidney Center. Administrative services are located at the Blagg Pavilion in Lake Forest Park, Washington adjacent to the Lake City Kidney Center.
The other community dialysis centers are the Lake Washington Kidney Center in Bellevue, Washington; the Scribner Kidney Center in Northgate, Seattle, Washington; the Mount Rainier Kidney Center in Renton, Washington; the Seatac Kidney Center in Seatac, Washington; the Auburn Kidney Center in Auburn, Washington; the West Seattle Kidney Center in West Seattle; the Port Angeles Kidney Center in Port Angeles, Washington; the Totem Lake Kidney Center in Kirkland, Washington; Kent Kidney Center Kent, Washington; and the Snoqualmie Ridge Kidney Center in Snoqualmie, Washington.