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Its Integration Into General Medical Practice

Angus I. Rae, MB, MRCP; Thomas A. Marr, MD; Richard E. Steury, MD; Loren A. Gothberg, MD; Robert C. Davidson, MD

JAMA. 1968;206(1):92-96.

Abstract
Twenty-seven patients with chronic renal failure have been trained in a community hospital for home dialysis. Six patients subsequently received renal homotransplants. The remaining 21 live an average of 230 miles from the training center, the majority in rural communities. Sixteen are cared for entirely by their local physicians. The other five live closer to the center and tend to be more dependent on it. The emphasis of the training is to make the patient as independent as possible relying for his needs on his local medical community. The local physician comes to the center for instruction while his patient is undergoing training. Thereafter, this physician is in contact with the center for advice when necessary. We believe that if dialysis were integrated thus into community medicine, many more patients with renal failure could be saved.

Author Affiliations
From Spokane and Inland Empire Artificial Kidney Center, Sacred Heart Hospital, Spokane, Wash. Dr. Rae is now at St Paul's Hospital, Vancouver, British Columbia, Canada.

Footnotes
Reprint requests to West 101 8th Ave, Spokane, Wash 99204 (Dr. Marr).

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ABSTRACT