Dialysis Outcomes Help Guide Decision Making

[okarol]

Dialysis Outcomes Help Guide Decision Making

Kathleen Lees k.lees@scienceworldreport.comFirst Posted: Nov 08, 2013 09:29 PM EST

"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.

http://www.scienceworldreport.com/articles/10791/20131108/dialysis-outcomes-help-guide-decision-making.htm

[Jean]

Oh My!!!! Here I am, going for my vein mapping this week, so I can start D hopefully not until the holidays are over with and I will be 75 in Feb. Damned Scary!!! But,it is what it is.

[okarol]

Jean, I think this refers to people who are having emergency dialysis related to other sudden illnesses.
 

[Jean]

Oh yes, of course, it does. Guess it just hit me wrong. Sorry. Going to have my veins mapped this week. After 6 years in Stage 4, I thought this would never happen. But, ( gulp) here it is.

[amanda100wilson]

Jean, it is ascary proposition, I know but as OKarol said, this does refer to energency patients.  Have you discussed dialysis options?  I know that you are going for vein graphing but that does not necessarily mean that you have been fully informed.  Have you considered PD as an option?  Do you have someone at home anle and willing to act as a care partner, so that you could do home hemo and gives the best outcomes.  If you go in-unit, you are mot compelled to go to ome unit if you are jot happy with it.  Unless you live in a rural area, there is usually more than one option.  Finally, a difficult qyestion but is dialysis  your option, or is it a forgone conclusion that you want to do it?  It is often foist on people without considering if this is what they want.  Anyway, I wish you all the best, and keep us informed.

[Jean]

Yes, I have discussed all the options, with my friends at IHD. my renal nurse, my hubby. I did think about PD, but, truthfully, even tho my mobile home is 1900 sq ft, there is not enough room for the supplies. Plus, my husband took care of his Mother in her final months, who was on PD and really was traumatized by it, so he is like 20 years older now than when he did that. I have been a caregiver twice in my life and would not wish it on any one .And the difficult question? I am not ready to die yet. I am not afraid, just not ready. I know when I was 30 and 40, I thought 60 was close to the doors of death. Now that I am 75, oh, heck no, it's not. However, I know it would be foolish to expect a transplant, when there are so many younger people who need a kidney. So, dialysis it is, and some one else can stick those ugly needles in me. Thanks for your input tho., and I hope you understand what I am babbling about.