Dialysis Outcomes Help Guide Decision Making
Researchers from the Mayo Clinic have found that nearly half of elderly patients who start dialysis over the age of 75 will die in a year or less.
"Many elderly patients and their families feel that they have no choice but to start dialysis, with several expressing regret from having initiated therapy," primary care physician Bjorg Thorsteinsdottir, M.D., lead study author and a health care delivery scholar with the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery said, via a press release. "The goal of our study was to develop evidence about dialysis outcomes to help guide shared decision-making among the patient, family members and care team."
Researchers examined four years of medical records for 379 patients who were at least 75 years old when they began the treatment at the Mayo Clinic in Rochester. The majority of patients at 76 percent started dialysis while in the hospital for chronic stress or a sudden medical emergency.
Mortality was found to be very high among these individuals, with as many as 40 percent of individuals dying within six months. The highest mortality rates were seen in patients that began dialysis in the intensive care unit, with only a 27 percent survival rate after a six month period.
Patients who began dialysis in the hospital were often unable to return home due to complications with the procedure, yet age alone was not a good predictor of survivor.
"We hope that these study results will help inform the difficult decisions that patients and family members must make about whether or not to begin dialysis," says Dr. Thorsteinsdottir. "We want to make sure that the treatment is congruent with our patients' goals and values."
More information regarding the study can be found via a report from the American Society of Nephrology's Kidney Week 2013 in Atlanta.