When Darrell Polletta woke up one morning, he noticed his ankles were swollen. Not thinking much of it, he took some Benadryl and left his Hobart home for work.
The next day, the swelling was worse.
"I pushed (the skin) in, and it was like Silly Putty," Polletta said. "I thought, 'That ain't right.'"
Doctors diagnosed Polletta, then 35, with focal segmental glomerulosclerosis, a rare disorder that causes kidney failure. The active motorcyclist and father of three was sidelined as he underwent a variety of treatments, including a kidney transplant, to keep him alive.
Polletta said the transplant did not help him as much as he had hoped. It got to a point where he no longer could leave the house.
"I was like, I can't live like this," Polletta said. "I'd rather be on the (dialysis) machine. I said take (the kidney) out."
Kidneys clean blood by filtering out about two quarts of waste products and extra water every day. When a person's kidneys fail, the only treatment options are a transplant or dialysis, an artificial process that removes waste through a machine.
About 15 years after his diagnosis, the 49-year-old pumps his blood at home through a device the size of a small refrigerator. The technology, called the NxStage System One, is a portable dialysis machine. Traditionally, patients with kidney failure visit a dialysis center three times a week, but the NxStage System One can be used at home and even taken on airplanes.
"(Patients) do the treatment on (their) time, not on somebody else's schedule," said Dr. Rafael Fletes, director of the Home Hemodialysis Program at DaVita Hammond at Home.
"You have a more empowered patient, you have a more motivated patient that feels better, and you have a patient who usually requires less medication than you would with the conventional type of treatment."
Polletta dialyzes six times a week at home. A functioning kidney works constantly, so the frequent at-home treatments help keep Polletta's blood free of natural toxins.
Fletes said studies are starting to show patients who undergo frequent dialysis, such as through the home program, have up to a 61 percent greater survival rate than patients using conventional dialysis.
Getting his life back
Polletta said he feels the difference.
"My blood pressure is perfect. My calcium deposits went away," he said. "Two years ago, they were telling me I wouldn't be able to walk."
A few weeks ago, Polletta bought a new chrome and black Harley-Davidson.
"It's a little victory, but it's nice when I can get out and ride," Polletta said, his mustache turning upward in a smile.
The FDA approved NxStage System One in 2005. Nationwide, about 1 percent of the 350,000 patients with kidney failure on dialysis use the machine, according to the Massachusetts based company NxStage Medical Inc. Now, about 3,000 units are being used across the country.
Fletes, whose Northwest Indiana DaVita clinics, are the only local providers of the in-home treatment, said the portable dialysis machine helps boost patient well-being while lowering hospital and clinic overhead.
But the treatment still costs money. Polletta said his medicine is "ungodly expensive." Three vials of his EPOGEN medication cost about $9,000, he said. It lasts him one week. The machine itself is valued at about $26,000, and he said each day of treatment costs $1,450.
All people with permanent kidney failure are eligible for Medicare. Polletta said between Medicare and a private insurance plan, the cost of his care is covered. And he said his routine is worth it.
Polletta starts his day before sunrise in a home office turned dialysis center. He sits in a reclining chair and inserts two needles into his left arm. For the next two hours his blood supply cycles through the machine 45 times.
"If you can't handle needles, you can't do this," Polletta said. "Normally, I just throw my computer in my lap, throw up my legs and kick back."
At one point before the home hemodialysis, Polletta said his skin hung over his shoes. Now he is planning to take his wife, Barbara, on a trip for their 10-year anniversary.
"I feel so good," Polletta said. "As much as it's a love-hate relationship, this thing keeps me alive."
Kidney failure by the numbers
Those with diabetes, hypertension and a family history of kidney disease are at a higher risk of kidney failure. Here's a look at kidney failure by the numbers:
* Among 300 million Americans, more than 20 million have chronic kidney disease, the precursor to kidney failure.
* About 470,000 Americans have end-stage renal disease, or irreversible kidney failure.
* More than 84,000 people die from kidney failure each year.
* More than 70,000 patients are on the waiting list for a kidney transplant. About 17,000 of those will get a new kidney each year.
Sources: National Kidney Foundation, U.S. Renal Data System.