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It goes without saying that dealing with a long-term or chronic illness is stressful. There are lots of decisions that need to be made, especially if you’re dealing with something that requires kidney dialysis.
One of the biggest decisions you may have to make is where you will get your dialysis treatment. One well-known clinic is the American Renal Associates clinic or ARA clinic. So, what should you know about ARA? What kind of treatment can they offer? Most importantly of all, what do real patients say about these clinics?
Let’s find out.
The American Renal Associates clinics focus on providing end-stage renal care to patients.
However, they’re one of many different healthcare companies that provide care for dialysis patients. So, before you make any decisions, let’s take a look at some key facts you should know about the ARA.
Established in 1999 and with almost 5000 employees, ARA has many years of experience caring for patients with renal failure. They are one of the largest dialysis providers in the US.
One quote from the ARA website reads: “Today, we are proud of our successful track record working with leading nephrologists around the country. We continue to expand our network of dialysis centers and improve more lives each year.”
While time is no guarantee of wisdom and experience, many patients do take comfort from a healthcare provider’s long track record of caring for patients.
The basic premise of dialysis seems fairly simple. The dialysis procedure filters the blood when a patient’s kidneys can’t do the job themselves. However, dialysis has come a long way since it was initially introduced in the 1970s. There are several different forms of dialysis available, and you and your doctor need to decide which type of dialysis is right for you.
The ARA offers four main types of dialysis:
In-center hemodialysis is the most “traditional” form of dialysis. Simply put, hemodialysis involves drawing blood from one needle in your arm, running it through a dialysis machine to filter and clean your blood, and returning it to your body via a second needle.
This type of dialysis takes around 3-5 hours, and the process needs to be repeated about three times a week, in a dialysis center. While this type of dialysis means that you’ll have medical equipment and trained medical staff on hand, it can be somewhat inflexible. Traveling costs and the time taken can also be something to think about.
However,in-center hemodialysis does have the benefit of allowing you to leave your medical treatment in the clinic. Once your dialysis is over, you can go about your life as normal, without needing to carry around extra medical equipment or keep anything like that in your home.
Peritoneal dialysis involves storing dialysis fluid in the abdominal cavity and filtering your blood through the abdominal membrane. This fluid needs to be changed several times during the day. However, this method of dialysis has a lot of benefits.
Firstly, peritoneal dialysis allows you a much more flexible schedule. There’s no need for weekly clinic trips since you can do the fluid changes yourself at home. Since your blood is being filtered and the fluid is changed daily, you’ll have much more freedom to eat and drink what you like.
Since peritoneal dialysis is the method that most resembles the way our kidneys filter blood, this method tends to have the best results and faster recovery times.
Almost without exception, most of us would rather stay comfortable in our own homes, if there’s an option. Peritoneal dialysis can be carried out at home, with either you or your care partner carrying out the regular fluid changes.
However, you or your care partner will need to have specialized training, to prevent any accidents during the procedure. You’ll also need to have a proper location for the procedures, as well as keep the appropriate equipment in your home.
Nocturnal dialysis is carried out – yes, you guessed it – at night. This allows for maximum daily freedom and is usually carried out at a dialysis clinic. The dialysis time can take between 6-8 hours and is repeated around three times a week.
Nocturnal dialysis is a longer and slower procedure, which makes it much easier on the body.
Speak to your doctor about which type of dialysis is right for you. Certain factors may need to be adjusted, such as the time and length of your treatments. For example, if you still have some kidney function left, your kidneys may still be able to filter some of your blood, and your dialysis procedure times will be shorter.
The ARA has 240 clinics in around 27 states. For more information on their centers and what you can expect to find, visit the website’s What To Expect section.
Of course, a well-written, informative website is not all there is to a good dialysis clinic. In our modern age of online reviews, businesses and companies live and die on their reputations and their reviews. Healthcare companies are, unsurprisingly, no different.
So, let’s take a look at a few real-life patient reviews about the ARA clinics. It’s worth noting that it’s difficult to assess the authenticity of an online review. However, we’ve taken all of these reviews at face value.
So, what makes a dialysis clinic a good one?
Of course, you want to receive reliable, high-quality treatment. However, the way patients are treated is also an important consideration. Let’s take a look at a few positive reviews for one clinic.
“I love this place, workers and staff are all welcoming and pleasant. I get my treatment here 3 times a week and it’s very relaxing and quiet.” – Confesor Borrero Jr
“Very clean clinic and pleasant environment and staff.” – Maria Pena
“A GOOD PLACE TO HAVE DIALYSIS!!!!” – Juan Guzman
It’s important to remember that dialysis is never a “nice” experience. At best, the procedure is boring and slightly inconvenient. However, it’s certainly necessary, and without it, you will die.
So, when the clinic medical staff takes pains to keep you comfortable and informed, this makes a great difference to your overall experience. In fact, the medical staff can easily turn an average clinic into a great one. For a more varied set of reviews from the same clinic, click here.
Not every clinic can be outstanding. Especially with nonprofit organizations, understaffing and insufficient equipment can be serious issues.
It’s not uncommon to find mixed reviews for a clinic. To illustrate, let’s compare two reviews we found for this clinic:
“The Staff are caring and loving, They make a difficult experience beautiful, the place is very clean.” – Percy Drakeford (rated five stars)
“Too many patients, so the older patients are treated roughly.” – Rodeanne Lewis (rated one star)
So, which of these reviews should you believe? Is one of them an outlier? As you can imagine, the second review is extremely worrying, especially if you’re choosing a clinic for an older friend or relative.
Simply put, your experience can vary from day to day. Certain members of staff may be more kind and competent than others. Choose wisely before deciding on an “average” clinic.
Unfortunately, some dialysis clinics are not acceptable at all. Problems can range from staff not communicating or treating the patients well, to dirty facilities and lack of medication and equipment.
Seeing a loved one being mistreated or ignored by medical staff can be even more frustrating and upsetting than if you were going through it yourself:
“For all of your techs. Treat all patients with love, attention, and a lot of patience. Sick people need support and care. I have family and friends receiving care at the Lehigh and 13th location, and it’s disgusting the kind of service that they get throughout the treatment and it saddens me. If you are not filled with compassion or have the heart and desire to help someone’s process go by smooth throughout the toughest hours of their day, then quit your damn job and work where people have no soul in the welfare office.” – Yanelee Jordan (rated one star, comment slightly edited)
We think it’s fair to say that this person was extremely upset by the treatment their loved ones had received in this clinic, which received an overall of three stars.
Dialysis clinics have a responsibility not only to provide medical treatment but to care for patients and support them through some of the most difficult times in their lives. Unfortunately, it seems that some ARA clinics fall short of this basic requirement.
If you’re starting a dialysis treatment for the first time, you probably have a lot of burning questions. While a good healthcare professional should fully answer any questions you have, that isn’t always the case.
So, let’s briefly discuss a few commonly asked questions about dialysis and ARA.
Dialysis should not be a painful procedure. At worst, you might experience a few uncomfortable side effects, like mild nausea or some abdominal cramps. However, these symptoms shouldn’t last, and can usually be dealt with by a medical professional adjusting your dialysis settings.
For traditional dialysis, you start by making yourself comfortable in a dialysis clinic chair. A surgeon will have previously implanted a portal in your arm, where blood can be withdrawn and returned. A medical professional will sterilize the area and insert two needles.
One needle will withdraw your blood, cleaning and filtering it, and the blood will be returned to your body via the second needle. This process shouldn’t feel uncomfortable or painful.
While the dialysis procedure is going on, you can read, watch TV, nap, or do anything else you feel like doing. Essentially, the worst part of dialysis is the boredom.
It’s also worth noting that you’ll need to stick to a particular dialysis diet. This is because dialysis isn’t as efficient as our kidneys’ natural function. You’ll need to limit your daily fluid intake, as well as limit the amount of certain foods you eat (for example, you should cut down on high-sodium foods).
If you don’t stick to your diet, the dialysis procedure won’t be able to properly filter your blood in time. You may suffer from fluid retention and other nasty side effects, or your dialysis procedure will just take longer. Sticking to your dialysis diet will directly impact how comfortable and effective your dialysis treatment will be.
Dialysis is used to treat end-stage renal failure. Renal failure can be caused by many different illnesses, most commonly kidney disease. At this stage, your kidneys stop filtering your blood effectively, and will no longer be able to filter your blood effectively and quickly enough to stop toxins, solubles, and waste products building up in your blood.
This can lead to dangerously high levels of fluid and toxins in your blood. If left untreated, this will be fatal.
If you have some kidney function left, you may be able to have shorter or less frequent sessions of dialysis. However, your doctor will decide how often you will need dialysis.
Depending on the cause of your renal failure, you may be able to stop using dialysis. For example, if the underlying cause of your renal failure can be treated, you’ll only need to have dialysis until your kidneys have recovered enough to resume their natural function.
ARA was recently purchased by Nautic Partners and its associated portfolio company, Innovative Renal Care on January 26th, 2021. Purchases and takeovers like this are usually not a problem in the healthcare industry, given a little time.
However this is a recent development, and it’s not yet clear how this takeover will impact ARA.
So, is an ARA clinic the dialysis center for you? Most of the reviews we checked were varied, with some worryingly bad reviews, and some impressive ones.
How can you decide for sure?
Never rush into a decision. A dialysis clinic isn’t just responsible for administering treatment – and occasionally comfort. They should also help you get on the track towards a kidney transplant if that’s your end goal.
There are pros and cons to ARA clinics. Here are the pros:
However, there are also some cons you should consider:
With around 290 ARA facilities in the US, you might be able to find a local dialysis clinic. The closer your clinic is, the fewer transportation problems you’ll encounter.
Before you decide on a dialysis clinic, spend some time researching the brand of the clinic and the specific center itself. Here are some factors to consider:
Lastly, try and take a look around the clinic itself before you commit. Some of ARA’s clinics allow virtual video tours of their facilities.
If you’re able to take a look around the facility, keep an eye out for any red flags. Possible red flags include a dirty or inefficient facility, lack of equipment or medicine, disinterested or unfriendly staff, miserable patients, or shabby furnishings.
You should feel comfortable, warm, and welcomed in a dialysis clinic. This isn’t a hospital emergency room – it’s a dialysis clinic, and you’ll be spending a lot of time here. You need to find medical professionals you can rely on, who will communicate effectively with you, and will help you work towards your end goals. These goals might include long-term treatment, a different type of dialysis, or ultimately a kidney transplant.
Essentially, you should trust your gut. Remember, you may be spending up to 15 hours a week in this center – so try and pick a nice one!
