Applying the principles of precision medicine to peritoneal dialysis could amended the flexibility and personalization of attraction for dialysis patients.
Precision medicine considers the environment, lifestyle, and genetics (or biologic characteristics), of a diligent to personalize care. This attraction whitethorn make much flexibility and individualization for patients connected peritoneal dialysis (PD), Rajnish Mehrota, MD, MS, FASN, University of Washington School of Medicine, said connected November 4 during a league astatine the American Society of Nephrology Kidney Week conference.
In precision medicine, besides considered to beryllium the aforesaid arsenic personalized medicine, the wellness attraction supplier works with the diligent and their unsocial acquisition to make a wellness attraction program that breaks distant from the “one size fits all” exemplary of galore attraction options.
The anticipation is that “people are dialyzing to live, alternatively than surviving to dialyze,” Mehrotra said during his session. “It would let radical to unrecorded the beingness they privation to live.”
There tin beryllium antithetic worth propositions that travel with each benignant of treatment, specifically location dialysis vs halfway hemodialysis. At home, Mehrotra suggests that patients worth privacy, freedom, and flexibility, whereas halfway patients whitethorn look for planned schedules, socialization, and to enactment with wellness attraction professionals who recognize their therapy and person had acquisition with it.
“Not lone bash antithetic radical measurement these issues differently, however they measurement them tin besides alteration implicit time,” Mehrotra said.
Mehrotra discussed past initiatives that propelled personalized medicine into the mainstream, which includes All of Us, an inaugural that was portion of the 2015 Precision Medicine Project nether erstwhile president Barack Obama. This programme had a extremity of enrolling 1 cardinal genetically divers US participants to cod information connected their environment, lifestyle, and health.
The Kidney Precision Medicine Project was aboriginal created to redefine/reclassify communal kidney diseases and place the pathways, captious cells, and targets needed to make caller therapies for genetically divers people. Mehrotra besides stressed the value of knowing the load of antithetic dialysis modalities successful precision medicine, arsenic is the load of the illness itself.
“There are galore dietary restrictions, predominant hospitalizations, IV solutions...It’s an highly precocious load and [I] admit the precocious load of treatment,” Mehrotra said successful the session. “I bash not cognize immoderate different chronic condition…[that] requires specified long, sustained changes successful people’s lifestyles—I bash not cognize of different disease.”
When prescribing PD, determination should beryllium galore considerations, of which helium suggests flexibility is an important one. Though determination are inflexible factors, specified arsenic the attraction of electrolytes oregon container storage, patients person flexibility successful choosing the benignant of bag, the hours connected to dialysis, the clip of day, and wherever they privation to person it.
In a survey done by Bio-PD, it was determined that genetics besides play an important origin successful precision medicine. The findings suggest that genes tin power creatinine, the peritoneal solute transport rate, and ultra-filtration capacity.
"We person the tools to connection flexibility successful personalized medicine," Mehrotra said
Reference
Mehrotra, Rajnish, MBBS, MD, MS, FASN. Developing Personalized Medicine for Dialysis Patients. American Society of Nephrology. November 4, 2022. ASN Kidney Week.
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