Mission Hospital doctors launched Asheville dialysis program

Each weekday morning, hundreds of people around Western North Carolina go to a kidney dialysis center for a treatment that keeps them alive. Without such treatments, many of those people would be dead within a week or two.

This life-saving procedure is available to so many people in our region largely because of the work of physicians Artus Moser and Denny Crews. They were part of a wave of specialists who came to Asheville in the 1970s.

Prior to the early 1970s, having advanced kidney failure was usually a death sentence. There were only a few dialysis clinics around the country. 

Kidney transplantation was an option for those who had the resources but, for most, being told you had kidney failure was like learning you had terminal cancer.

Fast forward 50 years. In 2024, more than a half-million Americans get chronic, outpatient dialysis and about 250,000 are kept alive by functioning kidney transplants. 

In WNC, there are more than 600 people who go three times a week for dialysis at one of 14 clinics. About 200 more do dialysis at home. About 400 people in WNC are sustained by a working kidney transplant.

The revolution in what was possible for people with kidney failure started slowly.

Moser, the son of a high school principal in Swannanoa, graduated from medical school in Chapel Hill in 1964. He was exposed to dialysis during internal medical residency at Medical College of Virginia.

Moser was fascinated by the ability of dialysis to “snatch people from the jaws of death” but at MCV, dialysis was viewed mainly as an adjunct to the transplant program. There was no imagining that soon, thousands of people would use this technology to stay alive for years, independent of whether they were trying to get a kidney transplant.

When Moser came back to Asheville in 1970, he expected to work as a general internist. But the doctors he was joining encouraged him to set up a dialysis program in Asheville.

Moser went back for an additional six months of dialysis training at MCV. Mission Hospital was persuaded to buy two dialysis machines and with three chairs, a small kitchen was set up as the “dialysis unit.”

In 1971, they dialyzed their first patient — a young man from Franklin who had been driving to Charlotte three times a week and wanted a facility closer to home. When Moser cautioned he would be their first patient, the man said: “You’ll do fine, doc. Let’s get started.”

The treatment did in fact go fine, and soon, more patients from across the region found their way to that little converted kitchen.

Crews joined Moser in 1972, coming to Asheville after medical training at Vanderbilt and Johns Hopkins. He shared Moser’s love of taking care of very sick, complicated patients and his interest in dialysis.

In modern units, there are foot-thick manuals of procedures, covering every detail of dialysis. In those days, “we had to figure out everything as we went along,” Crews said.

Fortunately, there was a community of nephrologists around the state eager to share their experience with this rapidly changing technology.

In 1972, Congress authorized Medicare coverage for dialysis treatments, and the number of dialysis patients exploded.

Moser and Crews borrowed money to convert a grocery store into an outpatient dialysis unit. That was 1977, at which time there were 75 patients. Three years later, they built a state-of-the-art facility on McDowell Street.

Since there was only one clinic for the whole region, many patients had to drive two hours or more for their treatments. Because of that, they championed home dialysis and at one point had one of the largest home programs in the Southeast.

It all seems so routine now. The facilities are modern, operated by a multinational corporation, DaVita. The machines have many sensors and alarms, and there are layers of people to call if questions come up. It Is a far cry from the two open-tub machines where it started in 1971.

“We had no idea that it might grow like it did,” said Moser. Crews attributes the growth to Moser’s “vision,” and Moser says, “It couldn’t have happened without Denny’s ability to look at the numbers and see what was possible.”

Their love of medicine, their willingness to learn new things and their ability to effectively advocate for their patients laid the foundation for a program that has saved more than 10,000 lives over the past 50 years.

More:Opinion: Asheville has long history of cutting edge rheumatology treatments and advances

More:Opinion: Bipartisan bill for Living Donor Protection Act would provide key protections

Winfield Word-Sims is a nephrologist who worked at Mountain Kidney & Hypertension Associates from 1991-2023. He teaches at UNC Hospitals in Chapel Hill.

No Byline Policy

Editorial Guidelines

Corrections Policy

Source