Dialysis Improves Quality of Life

  • The number of people over the age of 65 with kidney failure is increasing.
  • Kidney disease and kidney failure are often treated with dialysis.
  • Researchers say dialysis can improve the quality of life for many people.

Kidney disease is a leading cause of death in the United States, affecting about 37 million adults, many of whom don’t know they have the condition.

When your kidney function becomes especially low, it’s considered kidney failure. One treatment for kidney failure is to receive a kidney transplant.

Although organ donation has doubled over the past couple of decades, there are still more than 92,000 people on the national transplant list waiting for a kidney.

For many older adults with kidney failure, another available treatment is dialysis, a prospect that can be frightening for some people.

However, new research shows that starting dialysis can help improve the quality of life in older adults.

The research was published today in the Clinical Journal of the American Society of Nephrology (ASN) and comes from six European nations — Germany, Italy, Poland, Sweden, the Netherlands, and the United Kingdom.

In it, researchers reviewed self-reported quality of life in people over the age of 65 both before and after dialysis.

So what do these findings mean? And what do experts have to say about it?

“Kidney failure occurs with the renal system is no longer able to remove waste and balance fluids and electrolytes,” Dr. Teresa Amato, the director of geriatric emergency medicine for Northwell Health in New York, told Healthline.

“For someone suffering from renal failure there may be little to no symptoms; or, as the disease progresses, many unpleasant side effects may occur,” Amato explained.

Some warning signs of kidney disease include:

  • fatigue
  • brain fog
  • nausea or vomiting
  • weight loss or poor appetite

“As these and other symptoms increase, their quality of life gets to a point where it is better to start dialysis to manage the symptoms,” Dr. Shree Mulay, a nephrologist and founder of the Kidney Experts in Tennessee, told Healthline.

Mulay explained that dialysis can be done either at home or in a hospital, depending on the circumstances.

“Factors that affect the choice [someone] would make include their current health and comorbidities, as well as their home living situation and the support system they may have available. No two individuals are alike and it is important to help [each person] hone in on the treatment option that is congruent with their values and lifestyle,” Mulay said.

None of this means that undergoing dialysis is easy.

“Dialysis is a time-consuming process requiring several (usually three) sessions per week. Each session requires several hours of being stationary and hooked up to a dialysis machine. It also requires transportation to and from the dialysis center and home,” said Amato.

“For some older adults the benefit on quality of life may not outweigh the risks or the time spent on travel and receiving treatment,” she added.

Dr. Alan Kliger is a nephrologist and clinical professor of medicine at Yale School of Medicine in Connecticut. He did not author this research but is a member of the ASN and chair of ASN’s Excellence in Patient Care Advisory Committee.

Kliger told Healthline, “All forms of dialysis, like all procedures, have potential complications, which can be compared and patients can decide where the risk/benefit ratio is for them. However, the third choice, no dialysis, is always available, but almost always means a shorter lifespan.”

In the new study, quality of life was measured both physically and mentally by using a 36-item questionnaire.

Mental quality of life components included:

  • mental health
  • role limitations due to emotional problems
  • social functioning
  • vitality

Physical quality of life also had four components, consisting of:

  • physical functioning
  • bodily pain
  • role limitations due to physical problems
  • general health

The questionnaire was taken every 3 to 6 months for the year leading up to dialysis and the year after.

“This study confirms what previous studies have shown — that as kidney failure develops (sometimes over many years) both physical and mental health declines and in the year preceding need for dialysis they decline sharply,” Kliger explained.

“The study further shows that following initiation of dialysis, that rapid decline stops — and appears to stabilize,” he added.

Experts say this key takeaway might be enough to affect your decision if you’re not sure whether to start dialysis.

“Quality of life is probably the most important factor for not just older patients but all patients that are in the place to have to consider the treatment options for renal failure,” said Mulay.

“If you or your loved one is suffering from kidney dysfunction, speak to your doctor about… what matters most to you or your loved one, as that is vitally important to understand prior to starting any treatment plan,” Amato advised.

“If you do decide to start dialysis, make sure to have frequent touch points with your doctor so that you can address quality of life issues frequently,” said Amato.

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