Posted on June 5, 2015

According to a new study in the Journal of the American Society of Nephrology (JASN), doctors are now placing their patients on dialysis sooner for advanced kidney disease. The earlier start to this treatment could be because physicians believe kidneys that function better are more effective for the initiation of dialysis.

(image credit Anna Frodesiak)

It appears that patients are moving to this course of kidney treatment earlier in their illness. While this decision could make a positive difference in kidney health, it also means patients will spend a much longer time on dialysis machines. Since this is a growing trend, researchers at the University of Washington examined the medical records of 1691 veterans who were prescribed by VA hospitals to start dialysis from 2000 to 2009.

The researchers of this study concluded that as the years passed, patients started dialysis treatment with greater levels of kidney function. But there were no measurable differences in illness intensity at the time of dialysis initiation. In other words, the percentage of the severely ill and the distribution of signs and symptoms around the start of dialysis didn’t change.

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In addition, researchers noted that cardiopulmonary and gastrointestinal signs along with weakness and/or fatigue were the most commonly documented symptoms of kidney issues. And even though treatments were periodically driven by the amount of kidney function without considering other indications, this practice was not more common in recent compared with earlier years.

The results of this study point to doctors changing their opinion over time on how soon patients should be placed on dialysis. These findings demonstrate that physicians have decided it’s more appropriate to begin dialysis when the kidneys are healthier than waiting for the disease to progress.

Furthermore, the study’s authors believe further research needs to be done. This effort will help the medical world to discover the benefits and harms of dialysis as compared to other approaches to treat advanced kidney disease.

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