The lone nephrologist in Casper and one of only about four in the state will close his practice to work as a general physician at the Veterans Affairs' Casper Outpatient Clinic.

Dr. James Rupp, a kidney doctor, will close Wyoming Nephrology and Hypertension July 31 but continue to oversee patients' care at Wyoming Kidney Center, the dialysis center in Casper.

Dialysis becomes necessary when a person loses 85 to 90 percent of his or her kidney function. Dialysis removes waste from the body, balances certain chemicals and helps control blood pressure.

"The dialysis patients need care until we find a replacement," Rupp said. "For those patients, it's life-sustaining. If they don't get dialysis, they die."

Rupp serves as an administrator at Wyoming Kidney Center, which is owned by Ambulatory Services of America.

The closing of his practice affects patients he sees about every six months for kidney problems.

In an interview in October, Rupp said if he didn't find help, he was going to have to give up his outreach clinics and cut back his practice. He was on call at Wyoming Medical Center 24 hours a day because he was the only kidney doctor in town.

He said he is no closer to having help now than he was in October. Wyoming Medical Center has been trying to recruit another nephrologist to the area for more than a year.

"I am no longer willing to do it all," Rupp said. "It's a lifestyle choice. I will work from nine to five at the VA, and the salaries are the same."

Wyoming Medical Center already brought in locum tenens -- traveling physicians -- to see nephrology patients at Sage Medical Group, said Mike Phillips, spokesman for the hospital.

Several traveling nephrologists will cover this summer on two-week rotations. Starting in October there will be a locum tenen on contract for a year.

The hospital is committed to finding a replacement, Phillips said, and there shouldn't be a lapse in care.

"A lot of it's finding the right candidate," Phillips said when asked about why the hospital hadn't found a nephrologist. "It's one of those high-demand specialties."

A nephrologist in Gillette will oversee much of the eastern part of the state and a nephrologist from Fort Collins, Colo. will see Rupp's patients in the Fremont County area, according to Rupp.

The administration at Memorial Hospital of Sweetwater County is looking for a nephrologist to take over for Rupp, said Jason Jones, dialysis unit manager. The hospital might also use locum tenens.

The hospital needs someone to travel to Rock Springs two to three times a month, see dialysis patients and hold clinics for patients with less severe kidney problems.

"There is not the patient population to support a full-time nephrologist," Jones said.

Contact health reporter Allison Rupp at (307) 266-0534 or allison.rupp@trib.com.

She is not related to Dr. James Rupp.