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When Paul Kressin thinks of Christmas, he is reminded of the winter just after he was diagnosed with kidney failure. “Christmas is always good,” he said. But that first year in 1999, when he began dialysis, was memorable and not least because the whole community gathered round. Kressin is a loan officer at Intermountain Mortgage Company and a real estate appraiser who was born and raised in Los Alamos.“The real estate community set up a medical account to help pay my bills and stuck a bunch of money in it. Gifts just appeared,” he said. “In the Christian community, there were a lot of what we call ‘golden handshakes,’ a handshake with money in it. A lot of people have been very supportive, even the ones who just ask, ‘How are you?’”Kidney disease has become one of the fastest growing causes of death in the United States, along with Alzheimer’s disease, according to the Centers for Disease Control. Some 400,000 Americans suffer kidney failure, and 20 million are at increased risk of developing the disease.In New Mexico, kidney disease grew by 2,389 dialysis patients in 2006, about a five percent yearly increase over the last three years, according to Kidney Care Partners, a national alliance of kidney patients and care providers. With a disease that disproportionately affects Hispanic and American Indian populations, New Mexico is especially vulnerable in view of these trends.The main cause of kidney disease is complication from diabetes or hypertension, part of the growing “metabolic syndrome” that also includes obesity.Weight is not a problem for Kressin, who has lost more than 60 pounds over the last eight years.Many people can take steps to avert such serious complications and for them, Kressin has some pointed advice.“If you don’t want it, take care of yourself,” he said.In his case, he thinks he got an unwanted side effect from a sulfa drug that was prescribed to treat an eye infection in 1995. The symptoms went away when he stopped taking the medicine. “The drug killed off my kidneys,” he said.At first, after his kidneys became dysfunctional he went to the Española dialysis clinic, for four hours of treatment three times a week, while a machine cleaned his blood.There were other therapies, including an unsuccessful kidney transplant in 2003 and 14 surgeries altogether. Now, Kressin is one of the first people in New Mexico to begin using a new home treatment, known as home-hemodialysis. Now, he can stay at home. He can work. There is less time away from his family. And, he said, with these treatments, he feels better than ever. How does he do it? “I’ve got a great family, a wife who loves me and four kids. I’ve got plenty of reason to live,” he said. “I get the strength from the Lord Jesus.”He spends every morning reading and praying. At the same time, he is virtually tied to heavy and very expensive machines that are in turn wired and plumbed into his home, so anything longer than an overnight stay remains a problem.A speech and debate coach for several years, including sometimes while he was in a hospital bed, he said, one of his best recent memories was watching his son speak in an original oratory competition in Wichita, Kan. That kind of travel takes a lot of advanced planning. One can’t just drop in on a local treatment center and take a seat.One very expensive piece of a much larger health picture that is constantly under political scrutiny, the future of kidney care is uncertain, not to mention educating the public on what it needs to do to reverse the epidemic.Kressin said that it is not easy to deal with the Medicare bureaucracy, but without it he would literally be dead. “Nobody could afford dialysis without Medicare,” he said. “Nobody has ever been denied dialysis. We do have a good system.”Hopes for the future include prospects of a true artificial kidney, something that could be worn on a belt.A pilot study published in The Lancet last week reported some positive results for a wearable hemodialysis device that works on a 9-volt battery and weighs about 10 pounds.But some limitations remain and the article suggests a reliable and efficient device is still at least a few years away.For Kressin, the ability to treat himself with his family’s help at home is already a major step.“I can live a normal life,” he said.