Rationale for PD
Dana Campbell, MD, Medical Director of The Kidney Institute Ltd., Milwaukee, Wisconsin, is a strong proponent of PD—when it is done correctly. "Patients do well and they're happy," claims Campbell. If you're talking about quality of life, "self-care is clearly the way to go," he adds.
Campbell was drawn to PD early in his nephrology fellowship. "I liked PD, " he explains, "it seemed more humane for the patients, and friendlier than hemodialysis." He followed up on his interest by volunteering to supervise the PD clinics at the Medical College of Wisconsin. In addition, he served as a site coordinator for the CANUSA clinical trials.
Results from the CANUSA trials turned many nephrologists away from PD. "The renal community concluded that the therapy was ineffective," Campbell recalls, "and they lost interest in PD." Campbell took different lessons from the CANUSA results. "We were underdialyzying," he claims, "but we were learning how to properly monitor and provide good care."
Campbell remains convinced that PD is not only effective, but also good for patients. In fact, he believes PD should be the first choice of dialysis therapy for almost all people with end-stage renal disease. "Everyone can do well for a few years, many for years beyond that." He also thinks that patients who start with PD have time to make decisions about fistulas, etc. when, and if, they need to switch to hemodialysis.