A 58 year old physician, one of the pioneers in introducing peritoneal dialysis for chronic renal failure, consistently coerces his patients into maintenance peritoneal dialysis rather that maintenance hemodialysis. By contrast, another nephrologist at the same facility, who is expert in hemodialysis, does not even consider peritoneal dialysis in the choices presented to newly uremic patients. At some facilities, home hemodialysis is not mentioned, while at a few others, home hemodialysis is promoted as the therapy most likely to permit long survival during maximized rehabilitation. A renal fellow observing the conflicting “hard sells” remarked to the chief of medicine that patients were being denied their rights under pressure to accept one therapy over another.
KeywordsPeritoneal Dialysis Uremic Patient Maintenance Hemodialysis United States Renal Data System Home Dialysis
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