Automated peritoneal dialysis for home use

Area of Science:

• Nephrology
• Renal Replacement Therapy

Background:

• Developed a parallel peritoneal dialysis (PD) program in March 1972 as an alternative to home hemodialysis (HD).
• Aimed to provide home dialysis for patients with remote locations or vascular access failure.

Observation:

• 36 patients initiated PD for home treatment over four years.
• 30 patients succeeded in home treatments, with 22 completing at least six months.
• Seven patients were treated for over one year.

Findings:

• No neuropathy observed, except in diabetic patients.
• No patient required blood transfusions, even post-nephrectomy.
• Slightly higher predialysis serum creatinine noted in prior HD patients (p<0.07).
• Lower serum albumin in PD patients compared to HD (3.3 vs 3.8 g/100 ml, p<0.05).
• Bacterial peritonitis occurred in 16/36 patients (22 episodes, incidence 1/14 months).
• Sterile peritonitis epidemic (40 episodes) resolved by changing machine techniques.
• Catheter failure in 15/22 long-term patients, but replacement was manageable.

Implications:

• Peritoneal dialysis is a feasible home treatment option for select kidney failure patients.
• PD can eliminate the need for transfusions in many patients.
• Careful technique and monitoring are crucial to manage peritonitis risks.
• Catheter complications are manageable, supporting PD's long-term viability.