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Peritoneal Dialysis - Past, Present and Future
Please note, this page is a summary of the full conference speech (click here for the full transcript).
Jaqueline
Campbell
Jacqueline Campbell qualified as a nurse from the North Lothian College of Nursing and Midwifery in 1989. Nine years ago she became interested in renal nursing, working at Edinburgh Royal Infirmary before moving to Baxter Healthcare as peritoneal dialysis clinical specialist.
There is an exciting time ahead for peritoneal dialysis, Jacqueline Campbell told the conference delegates.
"With the need to free hospital resources, it offers a cheaper alternative to hospital dialysis, but most importantly it is good for patients wanting to take control of their lives and fitting dialysis around them", she said.
"With all the research and development on the way,and also with the evidence being produced that it is likely to be a better first-line therapy, I personally believe that peritoneal dialysis will undergo a resurgence and return to vogue in the next few years".
The downside of peritoneal dialysis was that it was not suitable for all patients because of the weight of the fluid. You had to be motivated to do the exchanges yourself, and infection was synonymous with PD. But peritonitis rates had lessened to once every 18 months, thanks to keeping to the correct procedure and hand washing.
"PD is a nurse led therapy - now is this a downside or not?" Jacqueline asked.
Nurses were the experts in peritoneal dialysis, and the doctors tended to take a back seat. The downside was that doctors in the pre-dialysis clinics might come across as more positive about haemodialysis because they didn't know much about PD.
"Perhaps the most important downside of PD is that it's not really very exciting, it's never on the TV because there is nothing to see".
Biocompatible solutions and Automated PD were improvements in PD. Treatment nowadays was much more flexible with good backup, so that patients could expect to stay on the therapy for a longer time than five years ago. If a child needed dialysis, being on PD helped to preserve them from haemodialysis as long as possible. Instead of insisting on having a creatinine clearance of 60, physicians were taking a more holistic approach looking at how you were actually feeling about your therapy as a better marker for dialysis adequacy.
"Lifestyle is a big thing for PD", she said, and instanced Tony Ward who climbed Mount Blanc and cycled from John O'Groats to Lands End while on peritoneal dialysis. The message he was trying to get across was that his life before dialysis was climbing mountains and being on dialysis would not stop him.
"Whether your life before dialysis was climbing mountains or going up to the shops for the messages, you should be able to achieve that lifestyle again", she told the delegates.
"Maybe take it a bit slower, it might take a bit more training, but you have to make your dialysis work for you. Dialysis to live, not live to dialyse".
Please note, this page is a summary of the full conference speech (click here for the full transcript).
Next >>
Dr
Nick Richards - Public Private Partnerships for Satellite Dialysis
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