Sovereign Valentine, a personal trainer in Plains, Mont., needs dialysis for his end-stage renal disease. When he first started dialysis treatments, Fresenius Kidney Care clinic in Missoula charged $13,867.74 per session, or about 59 times the $235 Medicare pays for a dialysis session. Tommy Martino/Kaiser Health News hide caption
Sovereign Valentine and his wife, Jessica, wait as a dialysis machine filters his blood. Before finding a dialysis clinic in their insurance network, the Valentines were charged more than a half-million dollars for 14 weeks of treatment. Tommy Martino/Kaiser Health News hide caption
President Trump signed an executive order Wednesday proposing to change how kidney disease is treated in the United States. It encourages in-home dialysis and more kidney donations. Nicholas Kamm/AFP/Getty Images hide caption
Shauna Pelfrey talks to her husband, Dorian, while preparing for his dialysis appointment. Lynsey Weatherspoon for NPR hide caption
Undocumented immigrants often can't get routine dialysis care and have to wait until their condition worsens to get emergency care. Jake Harper/Side Effects Public Media hide caption
William Scott (right) and his wife, Teresa, arrived at DaVita Med Center Dialysis in Houston on Tuesday morning, after missing William's appointment on Monday. "It's just good he got in here," she says. Ryan Kellman/NPR hide caption
Jason Early has been getting dialysis for the past 18 months after his kidneys failed following complications with Type 1 diabetes. Courtesy of Jason Early hide caption
Nurses teach patients how to use equipment and do peritoneal dialysis at home. Life in View/Science Source hide caption
Repeatedly waiting to start dialysis until a patient is having an emergency can lead to serious, long-term health problems. iStockphoto hide caption
What's the best way to connect patients to dialysis machines? iStockphoto hide caption