Harvard Medical School researchers have found out in a new study published in JAMA Internal Medicine that, older adults with end-stage kidney disease who start dialysis, a treatment that keeps their blood free of toxin, seem to die at higher rates than previously thought.
According to the study, more than half of older adults who started dialysis died within a year of beginning treatment, and close to one in four succumbed to the disease within a month of doing so.
In 2015, more than 120,000 people in the United States started dialysis and half of them older than 65. Since it involves the use of a machine to purify the blood of a patient from toxins, dialysis is commonly used as a treatment for end-stage kidney disease. Dialysis is typical of a bridge for some people to kidney plantation, but the majority of dialysis patients especially older people, do not get kidney transplants.
The study based its results on an analysis of a small but representative sample of national outcomes data among Medicare patients, 65, and older, who started receiving dialysis between 1998 and 2014. The sample included the results of 391 such patients. Of those, 68 were 85 years of age or older, 89 required assistance with daily activities, and 267 had four or more significant medical problems. Of the 391 patients in the analysis, 286, about 73percent, started dialysis in the hospital rather than on an outpatient basis.
About 23 percent of the patients, 88 people, died within a month of starting dialysis. Also, close to 45 percent, 173 people, died within six months, and nearly 55 percent, 213 people, died within the year. The research also showed higher death rates among several groups including those over 85, those who had four or more significant medical problems in addition to kidney failure, those who started dialysis in the hospital, and those who, even before starting the dialysis, needed help from other people with basic tasks of daily living such as eating and bathing.
The U.S. Renal Data Registry (USRDS) is the most primary major source for mortality statistic for patients on dialysis, and the National Institutes of Health maintained it. It shows a mortality rate of approximately 30 percent among older adults starting dialysis. However, this source only includes patients well enough to receive dialysis outside of the hospital. The research also said that in reality, nearly three-quarters of patients start dialysis in the hospital and some do not survive long enough to make it to outpatient dialysis.
The recent analysis included results among such hospitalized individuals, including hospitalized dialysis patients in the final tally boosted the previously reported death rates to more realistic levels.
