Studies on the therapy of chronic ureic patients receiving hemodialysis treatment at home

• Published in: The Japanese Journal of Nephrology Vol. 13; no. 3; pp. 487 - 502
• Main Authors: Kobayashi, Kaizo, Shibata, Masao, Kato, Katsumi, Maeda, Kenji, Imai, Tsuneki, Ohta, Kazuhiro, Yasuda, Bunji, Kawaguchi, Shunsuke, Tsutsui, Shuichi, Yamazai, Chikao, Manji, Tadatomi, Nomura, Takehiko
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Nephrology 30.05.1971
• ISSN: 0385-2385; 1884-0728
• DOI: 10.14842/jpnjnephrol1959.13.487

Recently, hemodialysis therapy has been popularized in Japan, but little work has been done concerning the study of hemodialysis in the home. We have endeavored to develop a safe, economical and practical.l system of home dialysis. The purpose of this communication is to describe the improvement of the equipment for home dialysis to explain the reduction of the initial and operating costs, and to consider some of the social problems involved. The summary of the paper is as follows :1. In the last three years, we trained five male and two female patients for hemodialysis treatment at home. Each patient spent three to four months in the hospital for the training. Unfortunately, the second patient trained, a medical doctor, died of cerebral hemorrhage. The youngest patient is 17, and the oldest is 53. They have various occupations, and most of themm live a considerable distance from the hospital. In the time since the program started, we have had no fatal or serious accidents, and there have been no severe complications directly related to hemodialysis.2. Our new machine for hemodialysis in the home consists of 300 liter bathtub, an effluent pump box, a head vessel, a main box, and a cart. One big improvement in this machine is that each one of the main parts can be exchanged or replaced separately. In order to stabilize negative pressure, a screw pump is used as an effluent pump. The cost of the machine is about one-third of the ordinary Kiil type machine. The dialysing effect of the new machine is the same as that of the usual type of machine.3. In order to keep expenses down, blood tubes and blood ports are used nine times, and dry chemicals are used.4. The paper emphasises that the cooperation of the patient's personal physician, and the understanding and cooperation of local administrative authorities are absolutely essential to solve the social problems thatt are an obstacle to home dialysis.5. Finally, the merits and demerits of home dialysis are summarized, and once again it is stressed thatt definite policies must be established and enacted to wive the problems of home dialysis.