As kidney function declines in older adults, the decision to start dialysis often comes with a sense of urgency, framed as a critical choice between life and death. However, a recent study led by Stanford Medicine challenges this narrative, suggesting that the timing and necessity of dialysis for some older patients may deserve more careful consideration.
The Study: Dialysis and Life Expectancy
The study focused on older adults with chronic kidney failure who were not candidates for kidney transplantation. Researchers examined health records from over 20,000 patients aged 65 and older, all of whom had an estimated glomerular filtration rate (eGFR) below 12—a common threshold for initiating dialysis.
The findings were eye-opening: patients who began dialysis immediately lived, on average, only nine days longer than those who waited, and they spent significantly more time in hospitals or care facilities.
For patients aged 65 to 79, the immediate start of dialysis actually resulted in 17 fewer days of life and 14 more days spent in inpatient care. This statistic underscores the trade-offs that come with dialysis, particularly for frail, older adults.
Quality of Life vs. Quantity of Life
One of the most striking aspects of the study is its emphasis on quality of life. While dialysis may extend life by a matter of days or weeks, it often requires significant lifestyle changes and comes with side effects like cramping, fatigue, and a rigorous treatment schedule.
The study highlights that for some older adults, the additional time spent undergoing dialysis and in care facilities might not align with their personal goals or preferences for end-of-life care.
Rethinking Dialysis as a Palliative Treatment
The study's authors suggest that dialysis should not always be presented as a straightforward choice for extending life. Instead, it might be more appropriate to frame it as a palliative treatment—primarily aimed at alleviating symptoms rather than prolonging life at any cost.
This approach allows patients and their families to make more informed decisions based on a clearer understanding of the benefits and drawbacks of dialysis.
Conclusion
This study from Stanford Medicine calls for a more nuanced approach to dialysis decisions, particularly for older adults who may face more significant trade-offs between life extension and quality of life.
As the healthcare community continues to explore these complex decisions, it becomes increasingly important for physicians to communicate the full spectrum of options and outcomes to their patients.
Understanding that dialysis is not a one-size-fits-all solution can empower older adults and their families to make choices that truly align with their values and life goals.
Join Our Chronic Kidney Disease Channel on WhatsApp!
Join our supportive WhatsApp channel for valuable resources, expert advice to help you navigate your CKD journey!
Why Join?
Stay Informed: Get the latest updates on CKD research, treatment options, and lifestyle management tips.
0 Comments
Post a Comment
Share your views