Patients should be consulted before dialysis treatment begins

Kidney dialysis patients should be educated about the different health benefits of both hemodialysis and peritoneal dialysis and then given a choice as to which they would like to undergo, according to a study conducted by researchers from the Johns Hopkins Bloomberg School of Public Health. It is one of the most comprehensive studies of the quality of life of patients with chronic kidney disease. The researchers expected to find that peritoneal dialysis allowed patients to function better, but, in fact, hemodialysis patients did better in some areas while peritoneal dialysis patients did better in others. The study, "Changes in Quality of Life during Hemodialysis and Peritoneal Dialysis Treatment: Generic and Disease Specific Measures" is published in the March 2004, issue of the Journal of the American Society of Nephrology.

End stage renal disease (ESRD) patients, who now number over 400,000 annually in the United States and cost the federal government more than $15 billion per year, require life saving therapy to replace the normal function of the kidney, according to the researchers. Peritoneal dialysis involves infusing fluid into the patient's abdomen through a catheter and uses the patient's tissues to filter toxins and excess fluid from the blood. The procedure can be done at the convenience of the patient four times each day for 30 minutes. Hemodialysis, in which the blood is circulated through an artificial kidney machine, requires lengthy visits to dialysis clinics three times each week for hours at a time.

Albert Wu, MD, MPH, associate professor in the School's Department of Health Policy and Management, said, "These findings have important implications for physicians who evaluate and treat patients with chronic kidney disease. This study also provides a good public health lesson. When it comes to kidney dialysis treatment, physicians should be discussing the ways that the treatment will affect each patient. There is no simple answer as

Contact: Kenna L. Brigham
Johns Hopkins University Bloomberg School of Public Health

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