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Making peritoneal dialysis a success for your patients
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End-stage renal disease is feared to be—and many times viewed as—a death sentence in the eyes of patients when they are first diagnosed. Many struggle with depression, medication management, fluid management, dietary restrictions, employment challenges, financial and support challenges, fatigue and pain, and often a loss of independence.
Related: Can peritoneal dialysis be a long-term therapy?
To help ease this transition, each kidney failure patient (emergent and non-emergent) should be extensively pre-assessed and educated regarding all ESRD therapy and non-therapy options. A patient’s long-term success with a dialytic therapy of any kind, including peritoneal dialysis, is predicated by a full understanding of therapy options and requirements, along with their related health and lifestyle benefits.
It is critically important that providers and the interdisciplinary teams have the education, resources, and desire to create opportunities that will allow for long-term successful peritoneal dialysis therapy for a wide range of patient situations. This includes the nephrologist and surgeon relationship, the approach to PD catheter placement techniques, and the transitions of care process. But it is imperative that nephrologists drive and champion the therapy.
How peritonal dialysis reduces the stress of kidney failure
There are many health and lifestyle benefits of PD that help patients combat the challenges they face living with kidney failure. Most importantly, patients have the opportunity to improve their quality of life by participating in their care plans.1 Connection to the interdisciplinary team—consisting of nephrologists, nurses, dietitians and social workers—increases the potential for long-term PD success. Proactive, comprehensive coordination of care along with prompt, creative and accurate interventions also increases potential for long-term success on PD.
Related: Growth slows for PD from 2014 to 2015
The self-care approach to PD empowers patients to perform their own therapy and control outcomes of their kidney disease. PD treatments are performed continu- ously at various prescribed times throughout the day and night which is currently the closest approximation to how healthy kidneys naturally work. Therefore, this therapy has the potential to continuously aid in fluid balance, blood pressure control, and the removal of harmful waste prod- ucts from the blood. Residual renal function is preserved for a longer period of time when patients begin on dialysis with this continuous therapy.2
Related: Why peritoneal dialysis works for me
As a pre-therapy, PD can also increase the possibility of transplant success.3 Patients report sleep patterns that are beneficial to their physical and mental health, which can allow patients to enjoy exercise, travel, and other personal interests.4
Lifestyle benefits of this mobile dialysis therapy and flexible schedule allow for most patients to perform therapy while at home, at work, at school or on vacation. Patients can spend more time with loved ones and doing the things they enjoy. With innovative and precise training techniques, patients with many physical, emotional, financial and schedule challenges can successfully perform and benefit from -by Patricia Herzog, RN
References
- Nissenson A. Improving outcomes for ESRD patients: Shifting the qual- ity paradigm. Clin J Am Soc Nephrol. 2013. doi: 10.2215/CJN.05980613
- Marrón B, Remón C, Pérez-Fontán M, Quirós P, Ortíz A. Benefits of pre- serving residual renal function in peritoneal dialysis. Kidney Int Suppl. 2008;108:S42-51. doi: 10.1038/sj.ki.5002600.
- Tokgoz, B. Clinical advantages of peritoneal dialysis. Perit Dial Int. February 2009: 29:S59-S61
- Kutner N, Zhang R, Barnhart H, Collins AJ. Health status and quality of life reported by incident patients after one year on haemodialysis or perito- neal dialysis. Nephrol Dial Transplant. 2005; 20: 2159–2167