Dialysis patient Cal (Kojak) Simmons celebrates his 57th birthday today World Kidney Day. Alcohol won’t be a part of his celebrations as it once was; those days ended about ten years ago when he was diagnosed with kidney failure. The diagnosis forced him to go on dialysis. Mr Simmons has been a patient at the Dialysis Unit for nine years.He’s one of about 130 people who visit the unit for treatment. In Mr Simmons’ case, he’s there three times a week, for about three-and-a-half hours each time. It has changed his life somewhat, but the father-of-three and grandfather-of-five takes it in stride, he knows he doesn’t have many options.“It’s either come here or look for a tombstone,” he states matter-of-factly.As Mr Simmons was being interviewed yesterday the nurses and support staff came around with a birthday cake and sang for him. They do that for all the patients and Mr Simmons says it is that kind of treatment that makes the place extra special; a happy place to be considering the circumstances.“I just come here and do what I have to do and leave here and go to work afterwards,” said Mr Simmons, a van driver for the Bermuda Physically Handicapped Association. “It’s never boring, I can read the paper, get some Zs [sleep] for three hours or watch TV or bring in a movie. The staff are pleasant.”Mr Simmons has no doubt about what caused his kidneys to fail. “I used to drink like a fish ... every day,” he admits. “Being out there drinking and partying is good but what is happening to you in the long run? We take things for granted. It happens all the time in life, it’s a phase we go through. I didn’t even know what the kidneys was all about.”He now understands how the kidneys function and how the dialysis machine works.While Mr Simmons is hooked up to tubes, blood is removed from his body and filtered, with his blood pressure constantly monitored by the machine.Dialysis is the removal of unneeded materials or waste products. Haemodialysis is the removal of these substances from the blood by filtering it through an artificial kidney with the help of the dialysis machine.But it is acknowledged in the medical field that the dialysis machine is unable to purify blood as well as a normal pair of kidneys would. “With dialysis you either come here or get a kidney transplant, and if you don’t come here you won’t live much longer,” Mr Simmons said. “It is like a family affair down here. Every patient down here gets a birthday cake on their birthday and [the staff] come around and sing to them.“It boosts their spirits. Some patients don’t like being here but there is no other choice unless they get a transplant.”Mr Simmons is one of 17 persons on the kidney transplant waiting list in Bermuda. In the meantime he is committed to three dialysis sessions a week, even on holidays. “If I want to travel I just talk to my case worker, they would make arrangements for me to get dialysed,” he explained. “They have it all over the world, even on cruise ships. If they find a match for me I have the funds put aside to leave [the Island] right away.”In the meantime he has had to modify his diet and is on daily medication. “We have to be very careful of our intake of liquids and foods. We have to moderate just about everything in our life, it’s a big change. I only eat one banana a month because of the potassium. I still eat the majority of the same foods but not as much as I used to. The dietitian lets us know what we can have and can’t have.”The Dialysis Unit caters to about 64 persons a day, six days a week. Staff begin work at 4am to prepare for the first patients soon after that. “The number of patients on dialysis has been steadily rising over the last few years. Unfortunately, Bermudians are disproportionately affected by renal disease,” said Lynette Thomas, medical director for the Dialysis Unit at the hospital.“In the majority of cases renal disease is related to diabetes, mellitus and hypertension, diseases which affect Bermudians in great numbers. We want to encourage modifying lifestyle choices which lead to the majority of end-stage renal disease.“People with diabetes mellitus or hypertension should have their kidney function assessed yearly. Our goal is to detect renal disease and offer appropriate therapy before patients reach end-stage renal disease and require haemodialysis. These steps will improve the quality of our Island’s health and well-being, while helping to control healthcare costs.”