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A better option for dialysis patients

At-home machines may make the procedure more convenient and beneficial. Some hospitals also find them more cost-effective.

February 03, 2003|Linda Marsa, Times Staff Writer

There's no doubt that dialysis saves the lives of people with advanced kidney disease -- without it, the toxins in their blood would quickly overwhelm their organs and kill them. But it comes with a price.

The lengthy treatments to cleanse the blood must be done three times a week, patients must adhere to strict diets while battling fatigue, and life-threatening medical problems are a constant threat.


For The Record
Los Angeles Times Wednesday February 05, 2003 Home Edition Main News Part A Page 2 National Desk 15 inches; 548 words Type of Material: Correction
Frequent dialysis -- In Monday's Health section, an article on daily dialysis regimens incorrectly said that dialysis was first developed in the early 1960s. In fact, the first artificial kidney was invented in 1942. It was the creation of a Teflon shunt in the 1960s that made it possible to treat patients long-term.
For The Record
Los Angeles Times Monday February 10, 2003 Home Edition Health Part F Page 8 Features Desk 3 inches; 113 words Type of Material: Correction
Frequent dialysis -- In last Monday's Health section, a story on daily dialysis regimens incorrectly said that dialysis was first developed in the early 1960s. In fact, the first artificial kidney was invented in 1942. It was the creation of a Teflon shunt in the 1960s that made it possible to treat patients long-term.


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It might not have to be this way. Doctors and patients are finding that more frequent dialysis can ameliorate many of the pitfalls experienced with the traditional process to remove toxins from the bloodstream.

About a dozen dialysis centers nationwide, including three in the Los Angeles area, now offer daily, at-home hemodialysis to approximately 300 to 400 people. Some patients cleanse their blood during a two- to three-hour session during the day; others prefer to do it while they're sleeping. Both use the same equipment found in dialysis centers.

"This is a way of getting patients back to a more normal lifestyle and improving their health," says Dr. Larry Idroos, chief of nephrology at Kaiser Permanente Los Angeles Medical Center, which has just launched a daily, at-home dialysis program. "In the future, as many as 50% to 60% of dialysis patients would be good candidates for this procedure."

Currently, about 250,000 of the nation's end-stage kidney disease patients have to travel to dialysis centers, where they sit at machines for three to five hours three times a week while their blood is removed, cleansed of toxins, and returned to their bodies. The treatment leaves people feeling drained or ill.

"It's very hard to live a normal life when you're on dialysis," says Richard Snyder, 48, of Trabuco Canyon. A former engineer who has diabetes, Snyder is starting a home dialysis program to prevent further deterioration in his health.

Because their kidneys no longer flush out fluids, people with end-stage kidney disease can't drink more than 1 1/2 quarts of liquid a day. Nor can they eat much food with potassium and phosphorous, which their bodies no longer metabolize properly. This can include red meat, nuts, dairy products, and many fruits and vegetables.

Between dialysis sessions, dangerous toxins accumulate in their blood, triggering a cascade of problems such as heart disease, high blood pressure, severe pain in joints where calcium collects, and impaired cognitive function.

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