Number Of Very Elderly Beginning Dialysis Increased Greatly In Last Decade

[okarol]

Number Of Very Elderly Beginning Dialysis Increased Greatly In Last Decade But Only 46 Percent Were Alive One Year Later

07 Feb 2007
Medical News Today 

The number of octogenarians (people aged 80 to 89) and nonagenarians (people 90 to 99) who began dialysis increased from 7,054 people in 1996 to 13,577 people in 2003, according to a new study from the Annals of Internal Medicine.

Overall, one-year survival rates for patients on dialysis did not materially change from 1996 to 2003, remaining at about 50 percent. Survival rates for these very elderly are substantially lower than those previously reported.

Researchers used data from a large national kidney data system. Risk for death was strongly associated with older age, inability to walk (nonambulatory status) and the number of chronic conditions a person had.

Authors suggest that physicians, patients and families considering placing an older person on dialysis should have a discussion that would include realistic estimates of survival, expected quality of life, and the patient's values. It may be, the authors say, that end stage renal disease is "really a reflection of underlying multi-organ system dysfunction" and may be better managed by a palliative approach.

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Annals of Internal Medicine tip sheet for February 6, 2007

Contact: Susan Anderson
American College of Physicians

Article URL: http://www.medicalnewstoday.com/medicalnews.php?newsid=62426

[renal30yrs]

The number of dialysis patients have increased period.

[okarol]

I think the authors were examining the wisdom of putting 80 and 90 year olds on dialysis,
and whether it actually helps given that their overall health maybe be declining, and that it
may not actually improve their situation.

When we often see in the news the statistic that dialysis patient's life expectancy is 3 to 5
years, it is skewed by the number of very elderly who live  a very short time after they
begin dialysis.

 

[Zach]

When we often see in the news the statistic that dialysis patient's life expectancy is 3 to 5
years, it is skewed by the number of very elderly who live  a very short time after they
begin dialysis.

Younger dialysis patients die pretty quickly too, when they fail to follow their dialysis prescription ...skipping treatments, cutting treatments short, going way overboard on their diet.  It just takes a few Hershey's bars to do oneself in.

[Sluff]

When we often see in the news the statistic that dialysis patient's life expectancy is 3 to 5
years, it is skewed by the number of very elderly who live  a very short time after they
begin dialysis.

Younger dialysis patients die pretty quickly too, when they fail to follow their dialysis prescription ...skipping treatments, cutting treatments short, going way overboard on their diet.  It just takes a few Hershey's bars to do oneself in.

I guess with that said you really can not put an age on transplantation and it's options. (dialysis)Correct me if I'm wrong but would it be wiser to make the determination based on patient compliability (or)rather ones health and rated life expectancy(lab reports)?  This is a touchy subject I know because I suck at compliance sometimes.

Opinions please...

[Zach]

I guess with that said you really can not put an age on transplantation and it's options. (dialysis)Correct me if I'm wrong but would it be wiser to make the determination based on patient compliability (or)rather ones health and rated life expectancy(lab reports)?  This is a touchy subject I know because I suck at compliance sometimes.

Opinions please...

From what I have read on this site and in conversations, if the transplant "team" believes the dialysis patient would be a high risk of non-compliance with the anti-rejection drugs (from prior dialysis observations, etc.), then the team can reject the patient.  But I don't know if there is a law regulating the issue.

A fully functional 78 year old person should receive dialysis.  It's the case of multiple morbidities and age that family members need to say enough is enough.  But that is terribly hard to do.

[Rerun]

I think when you are that old (80+) dialysis is just a way for the family to hang on and say their good-byes.  In my opinion it would be better to go on dialysis a few months so the kidneys totally poop out and then when they quit it would be a matter of days instead of suffering maybe weeks.  I know... some people always have urine function. 

Dialysis wouldn't be a bad option for older people if it weren't for all the access preparation surgeries.  That is Torture!

[renal30yrs]

Some very famous elderly refused dialysis and went - Arthur miller, Norman Mailor, and Art Buchwald.

[shivashankerprasad]

well i m 65 years old and going strong after two years of dialysis.
not many think that i will survive but it doesnot matter if u do adequate dialysis,maintain ideal hemoglobin and follow Neph prescription.
its not so difficult.
if u take good care of urself u will live a quality life no matter how old u are.

[Zach]

well i m 65 years old and going strong after two years of dialysis.
not many think that i will survive but it doesnot matter if u do adequate dialysis,maintain ideal hemoglobin and follow Neph prescription.
its not so difficult.
if u take good care of urself u will live a quality life no matter how old u are.

Exactly!

[angela515]

I agree with Rerun... When someone that old is put on dialysis, MOST (not all) of the time they dont even know whats going on... they cant do much or even walk... I think putting them on dialysis is torture, and someone should end their suffering.

[Rerun]

I agree with Rerun... When someone that old is put on dialysis, MOST (not all) of the time they dont even know whats going on... they cant do much or even walk... I think putting them on dialysis is torture, and someone should end their suffering.

I think that is the first time you have ever agreed with me!!      

                       

[Rerun]

Some very famous elderly refused dialysis and went - Arthur miller, Norman Mailor, and Art Buchwald.

"Went.."  Where?

[jbeany]

Some very famous elderly refused dialysis and went - Arthur miller, Norman Mailor, and Art Buchwald.

"Went.."  Where?

Much too philosophical for me, rerun.  Dumbledore called it "the next great adventure" or something like that. . .

[renal30yrs]

They are currently resting in heaven.  I read their public statements why they are refusing dialysis and go naturally.