Letner was 6 years old when he was diagnosed with kidney dysplasia. According to the U.S. Department of Health and Human Services, this occurs when the internal structures of one or both of the baby’s kidneys do not develop normally and cysts replace normal kidney tissue.
As a result of renal dysplasia, Letner’s kidneys had to be removed. He had his first transplant at 13, which lasted three years. His father was the donor.
Letner spent seven years on dialysis and was in his early 20s when he had his second transplant. The organ came from 40-year-old woman who died of a massive stroke.
“It’s never been lost on me that this was a family with kids involved. I’ve always greatly appreciated that the family was willing to make that donation and to think of others in a pretty tough time for them,” he said. Letner was able to keep that kidney for four years until he had to return to dialysis.
He received a third kidney from a man who died in a bar fight. However, post-operative complications resulted in a 13-day hospital stay and ultimately the loss of the organ.
Letner said the odds of receiving another kidney are slim. Because of his failed kidneys, he underwent blood transfusions for five years when he was a teenager. As a result, he was exposed to many human population antibodies. He said his panel reactive antibodies at 97 to 100 percent.
“That means I have been exposed to 97 to 100 percent of what they test for to determine if you are going to reject the kidney. It’s really going to be a really odd match for me to come up with somebody that they are going to be able to match me to,” he said.
His health issues were not a deterrent to his education. Letner was able to earn a Ph.D. in computational biochemistry in 1996 from Wright State University in Dayton, Ohio, and has worked in the IT industry. However, home dialysis has improved Letner’s day-to-day living
Although Letner set his own schedule now, issues in the past posed challenges to treatment. He recalls a time when he was in graduate school and the lack of schedule flexibility.
“I was having a really difficult time with policies about when you had to get to dialysis,” he said. “I needed to be there at 5 o’clock, but they couldn’t get me on the machine until 6 o’clock. The schedule flexibility was a big issue for me.”
He recalled a time when he arrived at 5:30 p.m. and had his run time cut by 30 minutes.
“I never missed a run, and I don’t tend to cut runs short,” he said. “To me, (cutting runs) is a big penalty to pay.”
Today, Letner conducts his dialysis treatment in the comfort of his Alpharetta home on Mondays, Wednesdays and Fridays. The run takes four hours, but he spends nearly an hour getting set up. Because of the needles’ large size, it takes nearly 20 to 30 minutes for his blood to clot post-treatment followed by more timing cleaning up.
“I almost view it as a second job, a part-time job. I have to schedule it. There is no getting away from it,” he said. “Quality of life for me sort of trumps all. … Going home for hemo dialysis, quality of life was a huge benefit of that.”
His parents moved in with him four years ago. His mother serves as his caregiver, which is necessary for emergencies. Overall, he savors the independence and convenience home hemodialysis provides.
Aside from tiredness and occasional cramps in his calves, Letner said the process is bearable. He watches television, works on his laptop and more.
“Anything you can do sitting in a recliner, you can do on dialysis,” he said.
Charlotte Fraiser, registered nurse and home therapy manager for Fresenius Dialysis Center in Marietta, trained Letner to conduct his home hemodialysis. He also gets monthly doctor checkups, his blood levels and medicines are monitored, and a technician checks the machine every month.
She said home treatment has many benefits to those who need it.
“When patients can do it at home, there is more control of their own life,” she said. “We can see them really prosper from home.”
Letner echoes this sentiment.
“You really do take a bigger part in your care. The more involved you are in your care, the better your outcomes are,” he said. “I feel empowered to be a part of the process.”
Treatment option programs are available at Fresenius for pre-dialysis patients interested in home care. Call (877) 867-7543 for more information.
Fresenius Medical Care has locations in Cobb and other metro Atlanta counties. For more information, visit www.ultracare-dialysis.com or www.fmcna.com.