Risk of Kidney Failure-related Death Takes a Dip

Although individuals with kidney failure have much higher risks of early death than the general population, it appears that the gap is gradually closing.

Efforts to improve care have resulted in improved survival of those with renal failure who were usually at an early risk of death.

Although rates of early death have decreased over time in patients with kidney failure, it is unknown if improvements merely reflect parallel improvements in the general population. To investigate, a team led by Bethany Foster, MD, MSCE (Montreal Children's Hospital and the Research Institute of the McGill University Health Centre) and Benjamin Laskin, MD, MSCE (The Children's Hospital of Philadelphia) examined changes in the excess risk of early death--over and above the risk in the general population--among people treated for kidney failure in the United States.

Chronic Renal Failure - Symptoms, Diagnosis, Complications, Treatment, Prevention
Chronic renal failure or chronic kidney disease is progressive loss in kidney function. The change is irreversible and is due to loss of nephrons of the kidney.

‘Decreases in excess mortality over time were observed for all ages and both during treatment with dialysis and during time with a functioning kidney transplant.’

Mortality Risk Assessment For All Age Groups

The analysis included 1,938,148 children and adults diagnosed with kidney failure from 1995 to 2013. The change over any 5-year interval between 1995 and 2013 in the excess risk of kidney failure-related death varied by age, with decreases from 12% for 65-year-olds to 27% for 0-14-year-olds.

The mortality rate of those dying from renal failure for all ages and both during treatment with dialysis and during time with a functioning kidney transplant reduced. The largest relative improvements observed for the youngest individuals with a functioning kidney transplant. Absolute decreases in excess kidney failure-related mortality were greatest for the oldest patients.

Urology Paediatric Emergencies - Trauma - Renal Failure
The testis can go for a twist inside the sac it is held. This results in loss of blood supply. If left untreated for more than 6 hours the testis loses function.

"We showed that all age groups have had significant improvements in mortality risk over the past 22 years. Some of the improvements were due to improved access to kidney transplantation and to longer survival of kidney transplants, but there were also improvements that can only be attributed to improvements in the care provided to people treated with dialysis and to those with kidney transplants," said Dr. Foster.

"This is important given the huge investment of resources in caring for these patients; we have shown that these investments have made a difference."

Advertisements

Acute Renal (Kidney) Failure- Causes, Symptoms, Diagnosis, Treatment and Complications
Acute renal failure is the sudden cessation of the functioning of kidneys, that can be due to reduced renal blood flow, damage to renal tissues.

Dr. Foster noted that the investigators expected to find decreased mortality rates for all age groups except those in late adolescence and early young adulthood. This age group often has difficulty adhering to recommended treatments, and there is sometimes a breakdown in the continuity of care when young people are transferred from a pediatric healthcare facility to an adult care facility.

"We discovered that young people in this age group had no improvements in mortality risk between 1995 and 2006, unlike all other age groups, but started to have significant improvements after 2006," said Dr. Foster. "This may be because healthcare professionals became more sensitized to these problems in the early 2000s and have changed the way they care for these young people."