Kidney Unit Director Looking Toward Growth

              THE SHREVEPOHT TIMES Thurs,. Oct. 19, 1978 *A
(Times photo bv Lee Shfvefy)
I Dr. Brown in kidney unit
Kidney unit director
looking toward growth
By MARSHA SHULER
Of The Times Staff
Stephen T. Brown III has several
things on his mind these days. But all
of them are geared to one central
purpose — making life easier for the
kidney patient.
Brown is the new director of the
kidney dialysis unit and assistant
professor in the section of
nephrology in the department of
medicine at LSU Medical Center.
The 31-year-old doctor is already
looking forward to the day, not many
months hence, when the medical
center will be expanding its dialysis
facilities. Ultimate goal is at least 26
more stations to treat kidney pa-tients,
some of them to be in a new
planned out-patient facility located
out of the hospital proper.
Brown, a Missouri native, also has
in mind contination of some research
designed to improve the quality and
quantity of time a patient must
spend on the dialysis machine. The
research was started when he was
working at the University of Penn-sylvania.
And there's also a plan to work
with the urology department to de-velop
a kidney stone evaluation
clinic so that the incidence of kidney
stone passage can be decreased or
eliminated and kidney failure and
infection in turn curbed.
Brown made the decision in medi-cal
school that kidney work would be
his specialty and transferred from
the University of issouri to Pennsyl-vania
to get more specialized train-ing.
It was helping do research in the
field that triggered the decision.
And it was the opportunities he
found he would have at the medical
center as it develops its kidney trans-plant
center that drew Brown to
Shreveport.
"There is a relatively large un-tapped
population of patients with
end stage renal disease and a lack of
facilities," Brown said of the local
area's situation. This and the med
center's transplant effort which adds
another load of patients to be main-tained
before surgery brings the
need for a larger dialysis unit, he
said.
"Right now I see our limit as not
being able to evaluate at any accep-table
rate the number of people
available because they will also need
to be dialysized," he said. Because of
this the patients are having to be sent
away to other institutions, Brown
said.
With the additional dialysis sta-tions,
however, he sees that situation
changing.
And he hopes the stations will also
help in another of his goals — getting
more kidney patients back function-ing
in society. The quiet but de-termined
sounding Brown wants to
teach patients to run dialysis ma-chines
themselves and continue at
home training "where these people
will ultimately be able to run ma-chines
at home."
"We do some home training in
hemodialysis (a kind of dialysis
which has the patients blood flowing
in and out of the body getting,
purified of toxins) now but facilities
are limited. With the new facilities
we will be able to home train at the
beginning of recognition of need for
therapy," he said.
"I would like to see the trend move
back to selfcare because patients
can realize fuller rehabilitation in
their own homes," he said. The De-partment
of Health, Education and'
Welfare also helps provide financing;;
for purchase of the dialysis equip-ment
for at-home use.
Along those lines he is exploring
the use of peritoneal dialysis as a
chronic maintenance technique"
trying to find ways it can be adapted
for at-home use. Peritoneal dialysis
is a procedure where uremic poison-'
ing is removed from the body'
through a tube which is surgically'
placed in the body. Right now
hemodialysis takes 15 to 18 hours and
peritoneal dialysis 30 to 40 hours.
"My reason for looking into this is
to increase the efficiency of per-itoneal
dialysis so that it much more
greatly correlates to the use of;
hemodialysis," Brown said.
Peritoneal dialysis has several
benefits for at-home use, he said. "It
does not require two people to run at
home, only the individual himself.
We could get people at home easier,
and free up spare time," Brown said,
because it is a procedure that can be
done while the individual sleeps at
night.
Brown also wants to improve the
patient's survival rate while he is
one the dialysis machine. "Patient
survival on dialysis sometimes
comes close to them dying at a rate
of 10 percent a year," Brown said.
"There's a 50 percent life expectancy
at five years; 50 percent dead at five
years. If they can get a kidney
transplant, we can hopefully change
those statistics," Brown said.
Brown hopes to work on improving
their lot another way, trying to im-prove
life expectancy by helping find
ways to curb some of the causes of
death while on dialysis, so that if a
donor can be found the patient will
still be around as a candidate fois
transplant.
Kidney patients traditionally are
anemic. Bone disease and heart dis-ease
often develop while they are on
dialysis. Brown has done research in
Pennsylvania in each of these areas
— trying to come up with the whys
and hows.
Brown's new work at the medicar'
center is just getting underway, but
he's got his agenda set for the
months and years to come.