BAMC patients have new option for dialysis treatment

By Lori NewmanAugust 22, 2023

Hurricane Maria: Dialysis Treatment
Jesenia Santos, a dialysis patient at Fresenius Medical Care is prepared for her treatment by Nayeli Bustillos, a volunteer registered nurse, at Vega Alta Puerto Rico, Oct. 31, 2017. Nearly 100 Fresenius Kidney Care dialysis nurses have volunteered to relieve staff and help care for patients at 27 of the 28 dialysis centers that the company operates on the island of 3.4 million American citizens. (U.S. Air Force photo by Airman 1st Class Nicholas Dutton) (Photo Credit: Airman 1st Class Nicholas Dutton) VIEW ORIGINAL

JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas, Aug. 22, 2023 – Brooke Army Medical Center is now able to offer inpatients an additional option for dialysis treatment to manage kidney failure.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, about 14% of Americans have chronic kidney disease. Many of those people benefit from dialysis, a treatment used to filter waste products from the blood when the kidneys aren’t functioning properly.

BAMC now offers admitted patients two dialysis options: peritoneal dialysis or hemodialysis.

Peritoneal dialysis, a new service at BAMC, offers continuous filtration using the lining of the abdomen to filter the blood inside the body. A soft plastic catheter is surgically placed in the abdomen, and a sterile cleansing fluid is infused through the catheter. After the filtering process is finished, the fluid is drained from the body through the catheter.

In hemodialysis, blood is removed from the body and filtered through a man-made membrane called a dialyzer, or artificial kidney, and then the filtered blood is returned to the body. Blood needs to flow through the dialyzer for several hours to adequately clean the blood and rid the body of excess fluid.

“Generally, patients on peritoneal dialysis are able to maintain their residual renal function longer and have fewer dietary restrictions. They receive dialysis daily/continuously, as opposed to most hemodialysis patients who usually receive three-to-four-hour treatments three times per week,” explained BAMC nephrologist, Dr. Mai Nguyen. Additionally, using a cycler, peritoneal dialysis can even be performed at night while the patient is asleep, causing less disruption in daily activities.

“While we prefer not to have to dialyze patients, peritoneal dialysis has many advantages over hemodialysis, and the number of end-stage renal disease patients being managed as outpatients with peritoneal dialysis is increasing,” Nguyen said. “Previously, we either had to transfer these patients to another treatment facility to continue peritoneal dialysis or switch them to hemodialysis. We want to make sure that we have the capability to take care of all our beneficiaries as well as the trauma patients that require peritoneal dialysis.”

“Peritoneal dialysis is something that we have always wanted to do here,” added Air Force Lt. Col. (Dr.) Jesse Wickham, chief of Nephrology and program director for the Nephrology Fellowship. “Our fellowship program teaches it, and we are all certified to do peritoneal dialysis.”

“We were also extremely fortunate that our surgical and nursing colleagues have all been very supportive of this effort,” Nguyen said. “Having this capability will allow us to optimally care for our patients and provide a training platform for our trainees and staff.”

Wickham agrees. “Getting our trauma service and surgeons here more familiar with peritoneal dialysis may help us take care of casualties in the field in future wars,” he said.

BAMC leaders praised the nephrology team’s efforts to expand the dialysis options for patients.

“I am extremely proud of our nephrology team for the tremendous work they are doing to provide the best treatment options for our patients,” said Air Force Col. Heather Yun, deputy commander for medical services. “They are a great example of how the BAMC team goes above and beyond to offer cutting-edge care for our patients.”