By day, Jennifer Dupilka fights for justice for crime victims as an assistant district attorney at the Westmoreland County Courthouse.
At home, she has a different kind of battle — against her own body.
Four days a week, her husband, Ray Dupilka, leaves his job as a county detective and moonlights in health care in the extra bedroom turned dialysis clinic at their Unity home. He carefully inserts two lines into her arm to connect her to a hemodialysis machine that filters the waste and extra fluid from her blood that her failing kidneys can’t handle.
The couple settles in to watch Netflix for the next 2½ hours while the machine does its thing.
“This has been life changing,” Ray Dupilka said.
Jennifer Dupilka was put on a kidney transplant list this month for a living or cadaver donor with Allegheny Health Network and plans to do the same at a couple of other health systems in the region. The wait can be three to five years.
In the meantime, the couple has spent the past several months taking health care into their own hands, something they say has given Jennifer Dupilka, 50, flexibility in her daily schedule. Earlier this year, she would arrive at a dialysis clinic three times a week, usually between 4:15 and 4:30 a.m. After about 3½ hours, she would head into work at the Greensburg courthouse, where she handles domestic violence cases and drug court. In March, she prosecuted a trial after going to dialysis in the morning.
But when the couple, married 21 years, learned in-home dialysis was an option, the potential benefits were obvious. They switched at the end of April.
“I had no idea it existed,” Jennifer Dupilka said.
“They indicated to us that the at-home dialysis is less of a shock on the system,” Ray Dupilka said. “It gave us the flexibility to keep working. That was her main goal through all of this, to keep working.”
The Dupilkas’ home operation — “Ray’s Clinic” as it has become known — runs through Fresenius Medical Care. Dr. Brigitte Schiller, senior vice president and medical officer of Fresenius Medical Care Home Therapies, said about 15,000 patients in the United States use the same type of machine as Jennifer Dupilka. Even more take advantage of in-home options for peritoneal dialysis, which works in the body differently, she said.
“I became a big home hemodialysis advocate because I was part of the clinical trial in the early 2000s to bring this device to market,” Schiller said.
The National Kidney Foundation is collaborating on legislation that would make it mandatory for patients to get proper education on options for dialysis. The number of patients using at-home dialysis in the U.S. has increased between 2011 and 2021, according to the National Institutes of Health. The number of incident dialysis patients, or those whose treatment is relatively new, getting treatment at home rose from 7.4% to 13.4% in that time.
The use of at-home dialysis increased among patients who have been receiving the treatment for three or more months — 9.7% in 2010 to 14.1% in 2021, according to the NIH report.
Allegheny Health Network nephrologist Dr. Kalathil Sureshkumar said patients who do at-home dialysis typically get treatment more often than in a clinic, which means better results for their heart and overall health.
“If you can do more frequent dialysis, it’s usually better for your body,” he said. “That will translate into a better outcome.”
It’s an option that should be presented to all patients, Schiller said, because of the freedom it can offer.
“You do not have to be a lawyer to do this,” she said. “This is not dependent on educational background. Anybody can be taught to do this.”
Multiple surgeries
Jennifer Dupilka first learned 17 years ago that kidney issues might be in her future. An 8-pound tumor on her kidney and intestines that she said was related to childbirth was removed, followed by four more surgeries.
She has three adult children. The youngest is studying nursing, inspired by the medical issues the family has faced.
“She’s had no complications, but it’s left her with 3 feet of small intestine,” Ray Dupilka said, referring to the organ that is typically 22 feet long. “The surgeon told her at some point her kidney function is going to be compromised because of that.”
Five years ago, she was referred to a kidney doctor. A few years later, her kidneys started to fail. That left her with little energy after work.
Dialysis in a clinic began in October 2023.
“Once she got on the dialysis, the change in her was immediate,” Ray Dupilka said.
Most dialysis patients get their treatment at centers, Schiller said. The at-home option is a complete shift — patients can get treatment on their own schedule, even allowing them freedom to travel with their machines.
“A lot of the general population still does not know about this,” she said.
Waiting for a transplant
Fresenius Medical Care staff provides training and support. Ray Dupilka said it took a few weeks of training to get the hang of it and admitted it was a bit intimidating at first. That training includes the basics about the machine and infrastructure, as well as the workflow and ordering of supplies, Schiller said. An iPad monitors the patient’s vital signs and machine operation.
“Anybody who wants to go home and do dialysis at home should be given the option to do this,” Schiller said. “There are very few reasons not to do it.”
Jennifer Dupilka is hopeful she will get to go on her favorite type of vacation — a cruise — after the transplant. AHN does about 100 kidney transplants annually, Sureshkumar said. The best option is a living donor because the organ typically works better and lasts longer.
“We always encourage people to find a living donor. That’s the best option,” he said.
About 30% of AHN’s kidney transplants annually are from living donors, he said. For those generous donors, it is a laprascopic surgery and, with a small scar, they can be sent home from the hospital in a couple days.
Until Jennifer Dupilka finds her perfect match, she’s hesitant to go too far out of the area in case the call comes that an organ is available. She keeps her cellphone by her side, even in the courtroom.
“She approached it with a smile,” Ray Dupilka said. “You’d never know that she was going through this. It’s not something she would wear on her sleeve. She claims to be the healthiest sick person out there.”
Renatta Signorini is a TribLive reporter covering breaking news, crime, courts and Jeannette. She has been working at the Trib since 2005. She can be reached at rsignorini@triblive.com.
:quality(70)/cloudfront-us-east-1.images.arcpublishing.com/cmg/TMIMSW765BEYJEPLH7Q3DMRVWY.jpg?w=360&resize=360,270&ssl=1 "Atlanta Hawks conclude successful 2024 Jr. Hawks Summer Camps â 95.5 WSB")
