Peritoneal Dialysis Patients More Satisfied with Their Care

A study has found that kidney disease patients who used peritoneal dialysis at home were 1.5 times more likely to rate their care as excellent than patients who used hemodialysis equipment at a dialysis center. The findings were published in the February 11, 2004, issue of the Journal of the American Medical Association (JAMA).

Hemodialysis patients must spend three to four hours, three times a week, attached to a blood-cleaning machine at a dialysis center. Peritoneal dialysis patients, in contrast, can perform the 30-minute procedure four times a day outside the center on portable equipment, after training, and need to return to the center only monthly for checkups. 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 the catheter and allowed to dwell in the belly until wastes pass across the lining into the fluid. Once filled with wastes, the fluid is then removed from the belly via the same catheter.

In the study, researchers surveyed 656 patients at dialysis centers. The results showed that 85% of peritoneal dialysis patients rated their care as "excellent,” compared to only 56% of hemodialysis patients. Currently, only 10% of the more than 100,000 patients starting dialysis each year use peritoneal dialysis. The researchers speculate that the pressure to fill large, hemodialysis centers nationwide may be part of the reason for this, as well as lack of information provided on peritoneal dialysis.

"Our study suggests that the vast majority of patients undergoing hemodialysis could be making a decision on dialysis treatment on the basis of very inadequate information,” said Haya Rubin, M.D., Ph.D., professor of medicine at Johns Hopkins Medical Institutions (Baltimore, MD, USA) and a member of the research team.




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