Management of End Stage Renal Disease

Douglas Shemin, MD, focuses his clinical and research interests on the care of patients with chronic renal failure who are treated with maintenance hemodialysis or peritoneal dialysis. Says Shemin, "Although unquestionably lifesaving, dialysis therapy is far from perfect; mortality rates are unacceptably high, and cardiovascular and infectious morbidities are major concerns."

Recent and current projects have included:

• etiology and drug treatment of hypertension in chronic renal failure,
• determinants and therapy of the cardiovascular risk factor,
• hyperhomocysteinemia,
• in chronic renal failure, the effect of hyperhomocysteinemia on vascular access thrombosis in hemodialysis patients, and
• the effects of antibiotics and peritonitis on residual renal function in peritoneal dialysis patients.