Home therapy for kidney disease
Martin J. Schreiber, M.D.
Donald G. Vidt, M.D.
Robert J. Cunningham, M.D.
Renewed interest in home therapy using continuous ambulatory peritoneal dialysis and/or continuous cyclic peritoneal dialysis will be sustained as both industry and researchers engage in improving understanding of the peritoneal membrane, controlling the causes of peritonitis, and creating new ways of generating dialysate. Patients on home dialysis have the potential to accept responsibility more easily, attend school, or remain gainfully employed, thereby bolstering their position in the family structure while improving their overall quality of life. In patients with diabetic nephropathy, intraperitoneal insulin administration can control blood sugar, obviating the need for subcutaneous insulin injections. Early referral for evaluation of dialysis and efforts at rehabilitation are essential to overall success. Treatment should reflect the need to address total patient care through a well-constructed patient care team.