Medindia
Advertisement

Kidney Patients Start Dialysis Earlier Than Before

by Himabindu Venkatakrishnan on February 20, 2015 at 10:59 AM

 Kidney Patients Start Dialysis Earlier Than Before
Dialysis is being started progressively earlier by patients in the course of their advanced kidney disease, found researchers. This could be because doctors are embracing higher levels of kidney function as being appropriate for dialysis initiation. The findings come from a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN).

Over the years, US patients with advanced kidney disease seem to be starting dialysis earlier in the course of their illness, which could mean that some patients will spend a significantly longer time on dialysis. To understand why patients might be initiating dialysis earlier, Ann O'Hare, MD, MA, Paul Hebert PhD (University of Washington), and their colleagues conducted a study using the electronic medical records of 1691 veterans in whom the decision to start dialysis was made at a VA medical center from 2000 to 2009.
Advertisement

The researchers found that, as for the wider dialysis population, patients in the study were starting dialysis with higher levels of kidney function in more recent years. Over time, there were no measurable differences in how sick patients seemed to be at the time of initiation to explain this trend or in the documented reasons for dialysis initiation. For example, neither the percentage of patients who were acutely ill nor the distribution of different types of clinical signs or symptoms present around the time of dialysis initiation changed appreciably over time.

Cardiopulmonary and gastrointestinal signs and symptoms and weakness and/or fatigue were the most commonly documented. Also, while treatment decisions were occasionally driven by level of kidney function in the absence of other clinical signs or symptoms, this practice was no more common in recent compared with earlier years.
Advertisement

The results suggest that doctors' practices have changed over the years to embrace higher levels of kidney function as being appropriate for dialysis initiation among symptomatic patients with advanced kidney disease. "Our findings seem to highlight the influential role of opinion-based clinical practice guidelines in promoting earlier initiation of dialysis across a wide range of different clinical contexts over this time period," said Dr. O'Hare.

The authors noted that studies on the benefits and harms of dialysis compared with other approaches to managing cardiopulmonary, gastrointestinal, and other symptoms of patients with advanced kidney disease are needed.

Study co-authors include Susan Wong, MD, Margaret Yu, MD, MS, Bruce Wynar, PA, Mark Perkins, PharmD, Chuan-Fen Liu, PhD, and Jackie Lemon, BA.

Disclosures: This study was funded by the Department of Veterans Affairs. A.O., C.-F.L., and P.H. received research funding from the VA Health Services Research and Development Service. A.O. also received research funding from the Centers for Disease Control and the National Institutes of Health and has received royalties from UpToDate. S.W. is supported by the Clinical Scientist in Nephrology Fellowship of the American Kidney Fund.

The article, entitled "Trends in the Timing and Clinical Context of Maintenance Dialysis Initiation," will appear online at http://jasn.asnjournals.org/ on February 19, 2015.

Source: Newswise
Advertisement

Advertisement
News A-Z
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
News Category
What's New on Medindia
Stroop Effect
Plant-Based Diet may Reduce the Risk of COVID-19
Lower Respiratory Tract Infections Linked to Obstructive Sleep Apnea in Children
View all

Medindia Newsletters Subscribe to our Free Newsletters!
Terms & Conditions and Privacy Policy.

More News on:
Acute Renal Failure Dialysis Urinary Stones In Children Vesico-Ureteric Reflux Causing UTI in Children Hydronephrosis / Antenatal Counseling Kidney Disease Kidney Kidney Health Stones in Urinary Tract Renal Tubular Acidosis 

Recommended Reading
Dialysis
Dialysis is an artificial process for removing excess water and waste from the blood. Hemodialysis ....
Quiz on Dialysis
Dialysis is a common procedure performed in patients with kidney failure, especially those who are ....
Slide Multimedia Animation on Surgical Removal of Kidney or Nephrectomy - Animation
Graphical explanation of removal of kidney. This is sometimes necessary for a kidney that stops ......
Alarming Facts about Kidney Disease
The rising incidence of lifestyle related diseases like diabetes and hypertension has risen and ......
Acute Renal Failure
Acute renal failure is the sudden cessation of the functioning of kidneys, that can be due to reduce...
Hydronephrosis / Antenatal Counseling
Currently most pregnant women undergo one or two ultrasound scans during their pregnancy....
Renal Tubular Acidosis
Renal tubular acidosis/RTA results in acid content of the blood being higher than normal and that of...
Stones in Urinary Tract
Ask people who have suffered from urinary stones and they will tell you how excruciating the pain ca...
Urinary Stones In Children
There is a wide misconception that only adults develop stones. On the contrary kidney stones are ver...
Vesico-Ureteric Reflux Causing UTI in Children
Bacterial infection of urinary bladder can cause pain and burning sensation while passing urine. Abn...

Disclaimer - All information and content on this site are for information and educational purposes only. The information should not be used for either diagnosis or treatment or both for any health related problem or disease. Always seek the advice of a qualified physician for medical diagnosis and treatment. Full Disclaimer

© All Rights Reserved 1997 - 2021

This site uses cookies to deliver our services. By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use