By Robert Preidt HealthDay Reporter THURSDAY, April 25, 2019 (HealthDay News) -- The death rate for older Americans receiving dialysis for kidney failure may be nearly twice as high as
widely thought, according to a new report. For the study, researchers looked at 391 Medicare patients, aged 65 and older, who started dialysis, in which a machine is used to remove toxins from the blood. Nearly 23% of the patients died within a month of starting dialysis; nearly 45% died within six months; and nearly 55% died within a year, the investigators found. The highest death rates were among patients older than 85; those who had four or more major health problems in
addition to kidney failure; those who started dialysis in the hospital instead of on an outpatient basis; and those who, even before starting dialysis, required help with tasks of daily living such as eating or bathing. The study was published April 22 in the journal JAMA Internal Medicine. The death rates found in the study were nearly double those cited in federal government statistics. This suggests doctors and patients may be basing treatment decisions on overly optimistic
survival estimates, the researchers said. "Dialysis can seem like a magical cure for someone whose kidneys are failing, but our finding that half of older adults die within the first year after starting dialysis is sobering," said lead author Melissa Wachterman. She is an assistant professor of medicine at Harvard Medical School, in Boston. "When time is short, how you spend that time becomes even more important. Spending the better part of three days a week doing
dialysis may not be the right choice for everyone, and people should factor this new evidence into their decisions," Wachterman said in a school news release. In the United States, more than 120,000 people started dialysis in 2015, half of them over age 65. Dialysis keeps some people alive until they receive a kidney transplant, but most dialysis patients, particularly older ones, don't get transplants. Dialysis is not the only option for kidney failure patients. A more conservative
approach involves providing medications and other therapies to relieve the disease symptoms, without dialysis, Wachterman said. Patients generally don't live as long with this approach, but it spares them the burden and potential harms of dialysis, according to the researchers. "The goal in difficult clinical situations like this is shared decision-making, where patients and clinicians can work together to make choices that best balance patients' goals and values with the objective medical evidence," Wachterman said. She suggested that doctors may have been painting "an overly rosy picture" about the prospects for some patients considering dialysis. "We hope this new evidence can help patients and families cope with what lies ahead and empower them to make informed treatment decisions that are most aligned with their goals and preferences," she said in the news release. End stage renal disease (ESRD) is the last stage of chronic, or long-term, kidney disease. There is currently no cure for ESRD, but some treatments and surgeries may help extend someone’s life expectancy. This article discusses important information about ESRD, such as the associated signs and symptoms, some causes, and life expectancy details. ESRD can cause a wide range of signs and symptoms, as wastes, fluids, electrolytes, and minerals accumulate in the body. Failing kidneys may also become unable to fulfill other important bodily functions, such as helping control blood pressure, strengthen bone, and make new red blood cells. Someone with kidney failure may experience:
Someone with ESRD may experience most of or all of the above symptoms. Some or all of these symptoms may be severe and occur either all or at least most of the time. The causes of ESRD are usually conditions that damage or weaken the kidneys over time, eventually causing enough damage to significantly reduce their function. For example, one common cause of ESRD is diabetes. The kidneys filter wastes, electrolytes, and water from the blood using filtering units comprising tiny blood vessels. If these tiny blood vessels have exposure to high sugar levels in the blood, they can eventually narrow and become clogged. Without proper blood flow, the kidneys become damaged. Diabetes can also damage nerves that tell the brain when to empty the bladder, resulting in pressure from a full bladder that can damage the kidneys. If urine stays in the bladder too long, it also increases the risk of bacteria causing a urinary tract infection, which can spread to and damage the kidneys. Another common cause of kidney failure is high blood pressure. The bodies of people with high blood pressure push blood through the blood vessels with a lot of force, which can damage tiny blood vessels in the kidney. Some less common causes of ESRD include:
In some cases, the kidneys may fail suddenly, even within 2 days. Some common causes of acute, or sudden, kidney failure include:
To assess whether or not someone has kidney failure, a doctor will run tests to see how well their kidneys are functioning. They will diagnose ESRD when a person’s kidneys are functioning at less than 15% of the normal rate. The doctor will also check the levels of albumin and creatine, which are molecules associated with kidney function, in the person’s urine. To confirm a diagnosis of ESRD, the doctor may also order:
People with ESRD may receive dialysis or a kidney transplant. However, some people choose not to have either. Instead, they may choose to take their medications and monitor their diet and lifestyle choices as a healthcare team advises. During dialysis, a machine receives a person’s blood from their body and runs it through a filter called a dialyzer that removes wastes and excess fluids. The machine then reintroduces the filtered blood back into the person’s body. Most people who receive dialysis at a hospital or dialysis center need to have three dialysis sessions per week, with each lasting 2–4 hours. People who use a dialysis machine at home may require more sessions per week, sometimes four to six. Someone may also receive peritoneal dialysis, wherein the stomach receives and removes fluids several times daily to clean the blood. People receiving dialysis typically follow a food and fluid plan that may involve monitoring and limiting the intake of:
People with ESRD can often help manage their symptoms by:
Someone with ESRD may receive treatment with dialysis long term or until a donor kidney becomes available. Kidney transplants involve removing the failing kidney and replacing it with a healthy donor kidney. If someone decides not to receive dialysis or wait for a kidney donor, doctors may provide them with medications to help ease the symptoms and provide comfort until they pass. In some cases, there is no way to prevent kidney failure. This is the case when it is due to a genetic condition or malformation, injury, or infection. That said, the best way to prevent ESRD is to follow lifestyle and dietary habits that reduce the risk of developing the two leading causes of ESRD, diabetes and high blood pressure. For example, a person could try:
Many people with ESRD who receive dialysis regularly or have a kidney transplant can often live long, healthy, active lives. The life expectancy for a person receiving dialysis is around 5–10 years, though many live for 20–30 years. People who receive a donor kidney from a living donor tend to go 15–20 years before needing a new kidney. Donor kidneys from deceased donors tend to last 10–15 years before needing to be replaced. However, it is important to note that someone’s precise outlook or life expectancy depends largely on how well they follow their treatment plan and any additional health conditions they have. Even with dialysis treatment early in the course of the condition, an estimated 20–50% of people with ESRD die within 2 years. Having ERSD is also associated with frequent hospitalizations, higher healthcare costs, and metabolic changes. People with ESRD cannot survive long without dialysis or a kidney transplant. That said, many people with ESRD who receive either dialysis or a kidney transplant can live for decades. A person should seek medical attention if one or more of the symptoms associated with kidney failure or disease occurs. If they receive a diagnosis of ESRD, they should talk with a doctor about the pros and cons of different treatment options. How long can you live with Stage 5 kidney failure with dialysis?How long can you live with stage 5 CKD? If you choose to start dialysis treatment, stage 5 kidney disease life expectancy is five to 10 years on average, though some patients have lived on dialysis for 20 years or more.
Can you recover from kidney failure with dialysis?Acute kidney failure requires immediate treatment. The good news is that acute kidney failure can often be reversed. The kidneys usually start working again within several weeks to months after the underlying cause has been treated. Dialysis is needed until then.
How many days a dialysis patient can survive?Someone who starts dialysis in their late 20s can expect to live for up to 20 years or longer, but adults over 75 may only survive for 2 to 3 years. But survival rates of people on dialysis have improved over the past decade and are expected to continue improving in the future.
What is a common cause of death for dialysis patients?Sudden cardiac death (SCD) is the single most common form of death in dialysis patients, accounting for 20% to 30% of all deaths in this cohort. These patients indeed have a very high burden of coronary artery disease (CAD), and a proportion of SCD events could be due to obstructive CAD.
|
How long can you live with kidney failure on dialysis
Related Posts
Copyright © 2024 ko.wiewird Inc.
