New data show that survival and life expectancies are increasing among dialysis patients. These findings were presented at the National Kidney Foundation’s 2015 Spring Clinical Meetings held this week in Dallas.
“Declining mortality rates are the clearest evidence of improving outcomes in dialysis patients,” said lead researcher Eric Weinhandl, MS, PhD candidate, and principal investigator with the Peer Kidney Care Initiative. “The transition to dialysis is difficult, both physically and psychologically. However, clinical outcomes on dialysis are improving and patient survival is increasing. “
Between 2003 and 2011, unadjusted mortality rates fell in both incident and prevalent dialysis patients who dialyzed in freestanding facilities. In incident patients, first-year mortality rates fell by more than 15%. In prevalent patients, mortality rates fell by more than 19%. The decreases exceeded the 4% decrease in crude mortality rate among the general U.S. population.
Recent data published in the 2014 United States Renal Data System annual report also indicates that survival rates continued to better between 2011 and 2012.
Weinhandl noted the reasons for the decline were likely multifactorial and could include better pharmacologic management of cardiovascular disease, increasing vaccination rates, decreasing reliance on catheters for vascular access, and recent changes in anemia treatment.
“This data suggests that mortality risk in dialysis patients is modifiable,” Weinhandl said.
The study period also coincides with the publication and implementation of several Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines, which have provided evidence-based clinical practice recommendations for all stages of kidney disease since 1997.
“It is gratifying to see patients living longer on dialysis. Earlier detection of kidney disease and better management of its complications were the principal goals of KDOQI,”said Kerry Willis, PhD, Chief Scientific Officer, National Kidney Foundation. “Improved practice means that people are initiating dialysis in a generally healthier state, which leads to better long-term outcomes for kidney failure patients.”