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Vernon T. Williams doesn’t believe in coincidence or chance. The retired Navy officer from Mobile, Alabama, who spent many years on a submarine, believes that everything serves a higher purpose, and that dedication and commitment will make things work out in the end. “Being on a submarine, you learn discipline and teamwork, how to deal with good and bad news, and how to react quickly to new information. You evaluate the options, make a plan and implement it,” the 71-year-old says.

This mindset helped him navigate the rough waters of a serious personal health crisis. After recurring renal cancer claimed both of his kidneys, Williams started regular dialysis treatment in the summer of 2020. He quickly discovered that the Transitional Care Units, or TCUs, created by Fresenius Medical Care North America provided him with exactly the information, attention and structure he needed to prepare for his new life. This included the choice between various treatment options. He eventually settled on and trained for home dialysis.

At the TCU, care givers help Vernon T. Williams to prepare for his new life.

The care, personal training and education I received and the staff’s attention to detail was fantastic. Finding out you’re not alone gives you confidence when there’s so much to absorb and understand.

Vernon T. Williams
retired navy officer


By the end of 2020 there were already 130 TCUs. By 2021, their number is expected to almost double to 250.

Attention to detail

The upsides of going through a TCU are better clinical outcomes, lower hospitalization rates and an improved quality of life for patients on the one hand, and higher satisfaction rates for caregivers on the other.

Melissa Herman
Senior Director, Home Clinical Initiatives, Fresenius Medical Care North America

Starting the journey

Personal relationships

A TCU is carved out of an existing dialysis center and generally comprises four dialysis stations, all in a quiet setting. It is run by a dedicated nurse and often a patient care technician, who can build a bond with their patients. They rely on a range of specialists such as social workers, insurance coordinators and dietitians to support and educate a patient with a staged curriculum that takes into account individual recovery and readiness to learn.

“These are the people who will spend four intense weeks with a patient, educating them on dialysis, fluid management and explaining the different treatment options that best fit their life,” says Herman. Patients also get the opportunity to try out or get hands-on education about different types of apparatus, from in-center equipment to a peritoneal dialysis cycler or a home hemodialysis machine, and familiarize themselves with the technology.

“The upsides of going through a TCU,” adds Herman, “are better clinical outcomes, lower hospitalization rates and an improved quality of life for patients on the one hand, and higher satisfaction rates for caregivers on the other.”

TCUs are located within existing dialysis centers, usually in a quiet, low traffic area.

Getting ready for the next step

Williams came prepared, as would be expected of a Navy officer. But he still maintains that the four-week program made a big difference in getting him ready for home hemodialysis – the form of treatment he considered best suited to allow him to preserve his independence. “I like to do my homework, so I started researching and discussing the options with my wife in 2012 when I received my first cancer diagnosis. We worked out a plan, just in case.”

Back then, with the help of his nephrologist, Williams settled on home dialysis, in case he lost both kidneys, which did not happen until eight years later. “The information I received at the TCU in 2020, including going over all the available options, confirmed my previous research that home dialysis was the way to go.”

By the end of the four-week program, Williams was ready to begin training for home dialysis. “The TCU got me ready for the next step, and gave me the confidence to monitor my own treatment and understand details such as arterial and venous blood pressure. There’s a purpose behind everything you do.”  

Williams completed his training and brought home a NxStage System One machine so that he could perform dialysis himself, assisted by his wife.

Home dialysis


Around 45 percent of TCU patients choose home dialysis. The number of patients who haven’t been in a TCU, but choose home dialysis treatment, is much lower, at around 15 percent.

A great program awaits

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