Maryland specialists in kidney disease say that a decision to end the state's 19-year-old program that pays for dialysis treatments and medication will greatly imperil those with the disease.

Last month, the state Board of Public Works, acting on the recommendation of the Department of Health and Mental Hygiene and Gov. William Donald Schaefer, voted to end state payments Jan. 1, saving Maryland an estimated $3 million during the next six months.

"This decision will put a risk-prone population at greater risk," said James Carey, chairman of the Maryland Commission on Kidney Disease.

John Sadler, the previous commission chairman, said the government's action "is not only unkind and unwise, but dangerous."

Maryland's Kidney Disease Program, which Carey's commission regulates, pays benefits to more than 4,200 Marylanders with the disease. The program is used to pay for costly dialysis treatments and medications. Medicare pays for 80 percent of dialysis treatment. The kidney program pays 20 percent.

Health officials have said that kidney patients will find other means of payment through private insurance or Medicaid, the federal health program for the poor.

But Carey said that without private insurance, the end of the kidney program will cause "the pauperization" of patients. He said treatment costs will drain their assets until their incomes fall so low that they will qualify for Medicaid.

Without drugs paid for by the program, there will be more hospitalizations and deaths, Carey said.

James Burdick, head of transplant services at Johns Hopkins Hospital, said he fears that some transplant patients' systems will reject the new kidneys, because without the program, patients may be forced to do without medication. He called the governor's decision "wrong-headed."