Surviving dialysis

[circleNthedrain]

Crappy....maybe.  Delicious....definitely!

[okarol]

Hey — if I were the depressive type I'd be in the depths now. That old thread included contributions from Epoman and goofynina, who are no longer with us as well as Flip, who was determined to "be around for a long time yet" but stopped posting last year...

On the other hand, Zach is still here to balance the scales. 

  Prayers for Epoman, Goofynina and Flip...

  Yay for Zach!

[RightSide]

I was looking through some dialysis related stuff on the web and I was horrified to find this statement in the New England Journal of Medicine:

The 5-year survival rates between 1995 and 1999 were under 35% for both hemodialysis and peritoneal dialysis. Patients treated with dialysis are hospitalized on average twice a year, and their quality of life is often low.

Is this about right? Is the probability of my demise in the next 5 years really 65%? 

Well, that's on the average for patients living between 1995 and 1999.  Are you average?     And what year is it on your world?   

ESRD, as I'm sure you know, affects more old folks than younger folks.  So that tends to make the numbers look worse for "average" folks (under 60 years of age).

Plus, dialyzers were not anywhere near as efficient, 15 years ago, as they are now.  And meds were not as advanced as they are now.  Things have improved since these data were collected.

But having said that, I'll give you the hard truth:

Your life expectancy with ESRD and dialysis is likely to be significantly lower than it would have been if you had never developed ESRD.  Unless you get a kidney transplant and can stop the dialysis.

And the paper you cited, gave some possible (but as yet unproven) reasons why this might be so:  It could be due to dialysis only inadequately removing all toxins; or it could even be due to continual exposure of the body to the ostensibly "inert" materials of the dialysis equipment.

There are a couple of markers that can give you a better idea where you stand:

Albumin:  This is a marker for protein intake.  Too low and it indicates possible malnutrition.

C-reactive protein:  This is a marker for chronic inflammation.  Too high and it indicates inflammatory disease of some kind.

If you have both malnutrition and chronic inflammation, this can indicate what is known as "Malnutrition-inflammation complex syndrome." This is potentially LETHAL for us dialysis patients--a much lower life expectancy.  It behooves you to aggressively treat both the malnutrition and the inflammation, if you suffer from those conditions.



Edited: Fixed quote tag - okarol/admin

[spacezombie]

The thing about survival rates is that they just don't matter. You could be one of the healthiest people alive and end up getting stuffed in a wall like that Yale college student. You just never know what is going to happen in your life. All we can do is try and stay as healthy as possible. Everyone dies eventually, I figure our shot is pretty similar to that of the general public. 

[Bajanne]

The thing about survival rates is that they just don't matter. You could be one of the healthiest people alive and end up getting stuffed in a wall like that Yale college student. You just never know what is going to happen in your life. All we can do is try and stay as healthy as possible. Everyone dies eventually, I figure our shot is pretty similar to that of the general public. 

I'm with you!  I am determined to live as long as I can!  My brother was very ill when he started dialysis.  He was already going blind because of his diabetes.  At first they only dialysed him twice a week.  The doctors in the US had said he would last less than 5 years like that, but they still only dialysed him twice at home. Then after a few years they dialysed him 3 times.  Yet with all that against him, he lasted 10 years, only succumbing to cardiac arrest.

[dwcrawford]

That is so true.  I was going to die before I started it and  now I'm alive.  Don't forget about the proverbial Mac Truck! 

[lucyskid18]

Nobody can predict these things.... were all different and have different strengths!!! We live as long as we can carry and maintain our bodies!!!! The day we die is the day we decide to give up on ourselves and our life!!!!!! dONT worry!!!!! Be happy!!!!!!

[plugger]

I was looking through some of the posts at DialysisEthics and I recalled a post about prolonging a person's life on dialysis.  The post is some years old, but it still looks like good advice:

http://www.dialysisethics.org/forum/viewtopic.php?t=40

Hope it helps!