May 7, 2010

The Doctors
5555 Melrose Ave.
Mae West Building, Second floor
Los Angeles, CA 90038

Re: Kidney failure treatment options for patients

On behalf of Dialysis Patient Citizens (DPC) – the nation’s largest non-profit dialysis patient organization – thank you for your informative and poignant segment about organ transplantation and at-home dialysis as life-saving treatment options for people facing kidney failure. As you noted, thousands of Americans are awaiting transplants – and knowing more about their choices in treatment can make a major difference in their quality of life.

At DPC, we and our 22,000 pre-dialysis and dialysis patient members strive to ensure that all patients are educated about kidney disease progression and how to help delay or prevent the onset of kidney failure. Then, if faced with kidney failure – also known as end stage renal disease (ESRD) – we support all patients’ ability to be fully informed and choose the treatment that is best for them and their individual situation.

Fortunately, many strides have been made in dialysis care, and patients have more options than ever before. With that in mind, I wanted to remind you and your viewers that when choosing an at-home dialysis treatment, several care options exist in addition to the modality mentioned on your show. While each treatment works to effectively remove waste and extra fluid from the blood, in hemodialysis (HD) the filter is a artificial kidney known as a dialyzer and in peritoneal dialysis (PD) the filter is the peritoneum (lining of the abdomen).

Within PD and HD, there are five different modalities of dialysis, with each offering different pros and cons that patients should consider with their doctor. These modalities are:

• Continuous ambulatory peritoneal dialysis (CAPD): Manual form of PD that includes catheter use and no machine
• Continuous cycling peritoneal dialysis (CCPD): Form of PD using a cycler at night
  
• Conventional home hemodialysis: HD conducted at home three times a week
  
• Daily home hemodialysis: Shorter (two to three hour) treatments, conducted five to six days a week
  
• Nocturnal home hemodialysis: Nightly HD treatments conducted three or more days a week
  

While at-home dialysis treatment can offer many advantages such as greater flexibility in treatment schedule and being able to receive care in the comfort of home, still other patients may choose to dialyze at a facility in their community where they may receive hands-on care from a dedicated clinical staff.  Above all, we encourage anyone who is faced with kidney failure to do their own research and work with their nephrologist to choose which treatment is right for them.

At www.dialysispatients.org, we offer patients and their family members more information about available treatment options, dietary tips and other helpful guidelines, and a sense of community with other patients who are interested in sharing their own personal story with others.  Our experience is that a more informed patient is a healthier patient, and we strive to serve as a trusted information source for patients, their caregivers and others.
Thank you again for helping educate people about their treatment options when faced with kidney disease and kidney failure, and please let me know if we can ever serve as a resource for you.

Sincerely,

Chad Lennox
Executive Director
Dialysis Patient Citizens