Article Text

  1. M. A. Kleinpeter
  1. Tulane University Health Sciences Center, New Orleans, LA


Learning Objective To appropriately identify patients with chronic kidney disease (CKD) who may be eligible for home peritoneal dialysis programs. CKD is increasing in incidence largely due to increasing incidence of diabetes mellitus. The majority of patients with CKD are managed initially by general internists and referred to nephrologists for additional education, dialysis modality selection, and transplantation consideration. Often, patients are only aware of hemodialysis as the renal replacement option from their physicians when dialysis is required. Dialysis may be performed in the home environment by motivated and adequately trained patients. Traditionally, peritoneal dialysis is the primary home dialysis modality. However, home hemodialysis is available for a select population of patients. The index patient is a 63-year-old woman with a history of hypertension, diabetes mellitus, dyslipidemia, CKD, and iron deficiency anemia. Part of the CKD education program includes a visit to a dialysis unit to meet with nursing staff, social workers, and patients. Following this visit, the patient was interested in the home modality of peritoneal dialysis to maintain independence and quality of life. Following outpatient placement of a peritoneal dialysis catheter, the patient was trained for peritoneal dialysis. She continued home dialysis and maintained independence with a good quality of life. Her medical course was complicated by pancreatitis secondary to cholelithiasis requiring cholecystectomy. During Hurricane Katrina, she was able to arrange emergency delivery of home dialysis supplies at her temporary location following evacuation. She has since returned to her primary dialysis program without complications.

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