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Patients give nod to kidney dialysis at home

A first-of-its-kind patient satisfaction study suggests that many patients tethered to a life-saving artificial kidney machine that cleanses the blood stream of wastes might have preferred a second option -- home-based peritoneal dialysis that uses the lining of the patient's belly as a natural filter -- if only they had been given a truly informed choice.

The Johns Hopkins researchers found that after about several weeks of treatment, kidney disease patients who were given the option of peritoneal dialysis were 1.5 times more likely than artificial kidney hemodialysis patients to rate their overall care as excellent. Their study will be published in the Feb. 11 issue of Journal of the American Medical Association. Neither treatment is clearly superior to the other with regard to mortality and overall complications.

The kidney normally cleans wastes from the blood stream. If the organ stops working, to survive, patients must undergo "kidney replacement treatment" with either a scarce kidney transplant or more commonly a lifetime of dialysis. Peritoneal dialysis involves surgically and permanently placing a soft plastic tube or catheter into the lining of the belly. A sterile cleansing fluid is flushed through this catheter and allowed to dwell in the belly until wastes pass across the lining into the fluid. The fluid now filled with wastes is then removed from the belly via the same tube.

Generally, peritoneal dialysis can be conducted in several short daily sessions at home or work using portable equipment, whereas hemodialysis requires multiple visits to a dialysis center each week for hours at a time.

"Peritoneal dialysis may be a better option for more patients than are receiving it in the U.S.," says Haya Rubin, M.D., Ph.D., Professor of Medicine and Director, Quality of Care Research at Johns Hopkins. "Our study suggests that the vast majority of patients who are undergoing hemodialysis could be making a decision o
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Contact: Joanna Downer
jdowner1@jhmi.edu
410-614-5105
Johns Hopkins Medical Institutions
10-Feb-2004


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