Interview with VP of Home Dialysis Therapies for FMCNA

Mr. Keith Lester Vice President of Home Therapies Fresenius Medical Care Medical Care North America 920 Winter St., Waltham, MA interview with:
Mr. Keith Lester
Vice President of Home Therapies
Fresenius Medical Care Medical Care North America
920 Winter St., Waltham, MA 02451-1457

Background: Mr. Keith Lester is the Vice President of Home Therapies for Fresenius North America.
Mr. Lester works directly with the Directors of Fresenius Home Therapies and is the point person responsible for crafting the scope, vision and operational direction of the home dialysis teams. Can you tell us a little about your background?

Mr. Lester: I’ve had a rather diverse background in health care over the past 20 years. After graduating from Texas Tech University with degrees in German and biology in 1992, I managed durable medical equipment nursing locations in Texas, served as vice president of a disease-management company in Philadelphia and as the regional vice president for Fresenius Medical Care in Philadelphia, which was my first exposure to dialysis management. I left Fresenius Medical Care for one year and managed a dermatology practice in Wisconsin. I wasn’t able to tolerate the winters there, so I returned to Fresenius Medical Care in 2008 as vice president of home therapies. How did you become interested in kidney disease?

Mr. Lester: In 1999, my sister in Lubbock, Texas was diagnosed with kidney failure. I knew nothing about dialysis at the time, nor did we have a very good support network for family members. My family assumed Robin, at 30 years old, would get a transplant. Like many transplant candidates, though, the wait stretched out to over three years before she was able to get a cadaveric kidney in December 2002. Unfortunately she hadn’t gotten a hemodialysis access before her surgery, and when the kidney was transplanted, it was discovered that she had a nocardial fungal infection in her heart at the base of her central venous access catheter. Needless to say, after seven and half months of IV therapy she passed away. Since coming to Fresenius Medical Care I have learned a lot about dialysis. I can’t say that if I knew then what I know now that things would have turned out any different. Nevertheless, I think I would have been better prepared to support my sister if I had been more informed. What do you see as the main benefits of home treatment for ESRD patients?

Mr. Lester: When I talk to patients across the country about home dialysis they report that the greatest benefit is that it gives them their life back. While going to a clinic three days a week works for many patients, the ability to dialyze on your own schedule is a true benefit for others.  Home dialysis offers them the opportunity to continue to work, care for family members and travel. What treatment options does Fresenius Medical Care Home Therapies program offer?

Mr. Lester: At Fresenius Medical Care we have over 890 home programs across the U.S. and Puerto Rico. Our qualified staff is trained to provide education and training for both peritoneal dialysis and home hemodialysis. Regardless of the approach selected, our nurses are trained to help determine the best modality and best equipment for patients to be successful at home. How is Fresenius Medical Care working to increase awareness of and support for home therapies?

Mr. Lester: In September 2006, Fresenius Medical Care launched the Treatment Options Program (TOPs) – which provides free classes to patients and their families on dialysis and other kidney disease treatments. More than 95,000 patients have attended these classes, and we now have more than 400 renal nurses, dietitians and social workers trained as TOPs specialists. We offer free, weekly TOPs classes in every market across the U.S.  Patients can sign up for a class through our website, or be referred to a one-on-one session or group session run by a TOPS specialist by one of our physician partners, depending on patient need. We also launched a TOPs app last year that allows healthcare providers to easily refer patients for TOPs education from their smartphones. What challenges does home dialysis face in gaining greater acceptance from providers and patients?

Mr. Lester: The biggest barrier is the lack of extensive home therapy training for renal fellows (doctors being trained in nephrology). To address that gap, we have partnered with the International Society for Peritoneal Dialysis (ISPD), as well as the Advanced Renal Education Program to offer training seminars for renal fellows. Many fellowship programs also send their renal fellows to a Fresenius Medical Care home therapy program for hands-on experience. But while these alliances help there is still a huge need for additional education and partnerships with other fellowship programs. We have found time and time again that physicians or practitioners will not prescribe home therapies unless they themselves are comfortable with them.

Thank you, Mr. Lester.

Marie Benz MD – Editor of

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Not for specific medical advice. Please consult your physician for recommendations and questions. Editor: Marie Benz