I would also like to direct your attention to a graph that compares the expectancy of a normal year old male to a similar patient on dialysis, or one who has received a kidney transplant.
All the patients were at least 75 years old. One might deduce from this data that kidney failure patients who opt for dialysis will generally tend to live longer. Patients with advanced kidney disease will often have multiple other serious disease conditions like heart failure, diabetes, cancer, etc; what we physicians call.
And so, if we take another look at the data we have discussed above, we realize that life expectancy in patients who had other severe co-existing disease conditions like ischemic heart disease actually did not differ;!
In other words, in a patient who has severe co-morbidities, survival might be determined more by these conditions than by whether the patient is dialyzed or not. The take home message is that dialysis will increase your lifespan as long as you don't have multiple other serious illnesses mentioned above.
I will also direct your attention to Figure 2 from this article that reinforces what we just discussed. For patients who decide themselves to not be candidates for dialysis after a discussion with their nephrologists, an obvious question that arises is, "how would I feel"? Most patients are in fact more worried about this than about the possible reduction in life expectancy.
Further complicating predictions of life with ESRD is the reality that those fortunate in obtaining their kidney transplant from a live donor almost always live longer than an age matched recipient of a kidney from a deceased donor. Whether or not a kidney transplant is the correct treatment for any specific patient is a changing question in terms of upper age or cause of kidney disease. When dialysis treatment was first introduced, being older than 45 meant absolute exclusion from therapy.
Today, the average age of new dialysis patients in the United States is 64 years. Similarly, kidney transplants are now being performed in very old patients as well as in many instances when the cause of ESRD was considered reason to refuse a transplant.
The wait for a deceased kidney donor in New York, for example, is now nearly 10 years, meaning some dialysis patients on the wait list will not live long enough to get the desired transplant. Without question, the best choice, just about always, is to receive a well matched live donor kidney. In my experience, I care for kidney recipients who are cheerful and fully functional more than 30 years after their transplant.
It is unusual for those on dialysis to sustain a near normal life after 20 years. But often, someone with kidney failure will need a kidney transplant. It's not always possible to carry out a kidney transplant straight away, so dialysis may be needed until a suitable donor kidney becomes available.
If a kidney transplant is not suitable for you — for example, because you're not well enough to have a major operation — dialysis may be needed for the rest of your life. There are 2 main types of dialysis: haemodialysis and peritoneal dialysis. Haemodialysis is the most common type of dialysis and the one most people are aware of. Blood passes along the tube and into an external machine that filters it, before it's passed back into the arm along another tube.
At dialysis centres, this is usually carried out 3 days a week, with each session lasting around 4 hours. It can also be done at home. Some examples of a home dialysis schedule include:. Peritoneal dialysis uses the inside lining of your abdomen the peritoneum as the filter, rather than a machine. These findings highlight the need for a deeper understanding of what drives the prognostic expectations of patients undergoing dialysis and call for efforts to raise prognostic awareness and manage prognostic uncertainty.
Healio News Nephrology Practice Management. By Melissa J. Webb, MA. Read next. July 08, Receive an email when new articles are posted on. Please provide your email address to receive an email when new articles are posted on.
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