The past, the present, and the future of home dialysis

✍ Scribed by Barbara Delano

• Publisher: Wiley (John Wiley & Sons)
• Year: 2010
• Tongue: English
• Weight: 58 KB
• Volume: 39
• Category: Article
• ISSN: 0090-2934
• DOI: 10.1002/dat.20471

✦ Synopsis

am delighted to be the guest editor of this very important issue of Dialysis & Transplantation (D&T) that focuses on home dialysis. It is especially gratifying that some of the most important contributors to the fi eld have agreed to write about the past, present, and future of these treatments for end-stage renal disease (ESRD). With close to 400,000 patients in the United States on dialysis, 1 we tend to take these therapies for granted, which is why the article by Dimitrios Oreopoulos, MD, PhD, and Elias Thodis, MD, on the early years of chronic peritoneal dialysis and the article by John Bower, MD, about what it was like to be a true pioneer in offering home hemodialysis-particularly to an indigent population-are so compelling. 2,3 My own involvement with home dialysis dates from 1969 when, while fi nishing my renal fellowship, I was given the task of starting a home hemodialysis program at Kings County Hospital in Brooklyn, New York-a large city hospital that serves an inner-city population. By 1986, we had 84 patients actively performing home hemodialysis, 4 and then for the reasons stated by Dr. Bower, Mitchell Rosner, MD, and Christopher Blagg, MD, 3,5,6 in their articles in this issue, those numbers declined greatly-not only in our program, but also nationally so that in 2010, fewer than 1% of patients are undergoing hemodialysis at home. 7 In 1987, I started a peritoneal dialysis program that has trained approximately 200 patients. Nationally and at SUNY Downstate in Brooklyn, peritoneal dialysis is also decreasing. Following Dr. Bower's article on what home hemodialysis was like in the past, Dr. Rosner gives an elegant review of the exciting new interest in more frequent dialysis,