Jim Smith can take it with him on an airplane. He has hitched it on the back of his motorcycle for short trips. He’s also brought it on RV trips with his wife.

Using the portable dialysis machine has just become part of everyday life for Smith, who has chronic kidney disease and has been on kidney dialysis since 2004. He said he prefers the at-home treatment because it gives him more freedom.

“It’s done on my schedule,” Smith said in his RV — while on dialysis — in the parking lot of the Olympic Peninsula Kidney Center in Bremerton last Thursday. “I have the control back in my hand.”

Smith, of Indianola, hasn’t been going to a clinic for dialysis since he began using NxStage hemodialysis at home — or while traveling — in July 2007. Last week he and his wife traveled in their RV to the kidney center in Bremerton to talk to patients at the clinic of his benefits from using an at-home system. They spend about three to four months of the year living in Georgia.

“There are a number of therapies. There are alternatives,” Smith, 63, said. He just prefers this one.

The kidney’s function is to clean out and remove toxins to filter the blood and keeps the chemistry of the blood normal. It also removes waste and can control blood volume and blood pressure. People with chronic kidney failure do not have kidneys that function to 100 percent capacity and dialysis is required if the kidney has completely failed.

Once patients are on dialysis, they remain on it for the rest of their lives unless they are eligible for a kidney transplant. The dialysis acts like how a kidney would for the body.

Smith is not eligible for a transplant.

“I want the healthiest dialysis I can get,” he said.

And for him, the portable dialysis is the “healthier” choice because he is on dialysis about six times a week, while patients who go to a clinic typically go three times a week. He said two years ago his heart condition was weak but it has improved in due part to dialyzing more frequently.

Not only does Smith have the choice of when and where he wants to do his dialysis, overall he feels better because he doesn’t get a big shock to his system since he is doing it on a near-daily basis.

Doing dialysis three times a week can be more tiring to the body.

“It’s like shocking the system to almost normal. You go up and down and up and down,” said Dr. Connie Davis, professor of medicine in the division of nephrology at the University of Washington and director of Kidney Care Line, on how patients typically feel.

If patients are dialysizing on an every day, or more regular basis, they don’t have those wide swings and thus have more energy, can eat more normally and feel better all around, Davis said.

“It’s a personal preference. Practitioners do encourage daily therapy whether it’s hemo[dialysis] or peritoneal [dialysis],” she said. “It really is a step up in treatment.”

For Smith who is on hemodialysis, a shunt is placed in the vein whereas in peritoneal dialysis, a catheter is placed directly in the abdomen.

At the kidney center in Bremerton, there are about 100 patients who come in for in-center dialysis while the at-home dialysis number is at 21, according to Kay McFarland, the center’s home training nurse.

“In center, we try to accommodate but sometimes it’s just when a chair is available,” McFarland said.

Although McFarland said ideally, the longer one is on dialysis, the better it is, there are positives and negatives for everyone. At-home portable dialysis — which can be done more frequently — may not be the best option for all patients. She said that for some older people, their only social interaction is when they come to the center for their dialysis.

Davis added that patients who use portable dialysis need to be more active in their care because they are no longer just plopping themselves in a chair and having a practitioner do everything for them.

With Smith’s situation, he and his wife Claire were both trained to properly use the portable hemodialysis machine.

“Jim’s attitude is just wonderful. It was tough in-center,” Claire Smith said.

Some patients however have adapted to the routine of going to a center for their dialysis.

Hank Mann-Sykes, 72, said he has never considered an at-home portable dialysis machine because he doesn’t have the support system to be able to do that. His wife is a full-time teacher with the Central Kitsap School District.

“It’s like a part-time job,” Mann-Sykes said of going to the Bremerton center for dialysis three times a week.

While other patients sit in their chairs and watch TV while getting dialysis at the center, Mann-Sykes said he sits and thinks, often he has friends that come visit him — or he “does business.”

Involved in the Central Kitsap community, Mann-Sykes is constantly organizing a new project or recruiting people for a cause. He was a proponent for the YMCA in Silverdale and is on the Central Kitsap Community Council.

Although the time he is on dialysis is three hours a day, Mann-Sykes said the total time from when he gets home and back is about five hours. He added that usually he is wiped out from the dialysis and will go home and take a nap on his recliner.

Mann-Sykes was first put on dialysis in 1990 and then had a kidney and pancreas transplant in October of that same year. The filtration system of the transplanted kidney began shutting down and he was back on dialysis two-and-a-half years ago.

“It’s keeping me alive,” he said.

The number of people with kidney failure in the United States has been on the rise. In 2009, the Centers for Disease Control and Prevention estimated 26 million adults in the country with chronic kidney disease. The main cause of the disease is in connection to diabetes, said Davis adding that high blood pressure can also play a role. Chronic kidney disease is more common in men and has found to be more common in non-caucasians — such as African-Americans, she said.

Research that is coming out indicates that African-Americans more often carry a gene that affects the kidneys not performing well under certain situations, she added.

Whether patients are opting for the portable dialysis — Medicare covers the cost of it just as it would in-center dialysis — or not, for most of them the treatment is just another daily task they must go about.

“It’s like changing oil in the car,” Smith said.