Dialysis for the elderly: New evidence to guide shared decision-making

November 8, 2013, Mayo Clinic

New research from Mayo Clinic finds that half of elderly patients who start dialysis after age 75 will die within one year. The findings are being presented this week at the American Society of Nephrology's Kidney Week 2013 in Atlanta.

"Many and their families feel that they have no choice but to start dialysis, with several expressing regret from having initiated therapy," says Bjorg Thorsteinsdottir, M.D., lead study author and a scholar with the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. "The goal of our study was to develop evidence about dialysis outcomes to help guide shared decision-making among the patient, family members and care team."

Researchers reviewed four years of medical records for 379 patients who were at least 75 years old when they began at Mayo Clinic in Rochester. The majority (76 percent) started dialysis while in the hospital for a chronic illness or sudden medical event such as pneumonia.

Mortality was very high, with 40 percent of patients dying within six months. The highest mortality rates were seen in patients who started dialysis in the intensive care unit. Only 27 percent were alive after six months.

Patients who started dialysis in the hospital often were not able to return home. Of the patients admitted to the hospital from home, 28 percent died while in the hospital or were discharged to hospice, 28 percent were discharged to a nursing home, and only 37 percent were able to return home to independent living.

Age alone was not a good predictor of survival, and healthier elderly patients did better. Most deaths were preceded by a decision to withdraw life support, including dialysis.

"We hope that these study results will help inform the difficult decisions that patients and family members must make about whether or not to begin ," says Dr. Thorsteinsdottir. "We want to make sure that the treatment is congruent with our patients' goals and values."

Explore further: New approaches to assessing and protecting kidney health

Related Stories

New approaches to assessing and protecting kidney health

November 7, 2013
A variety of recent studies highlight new approaches to assessing and protecting kidney health. Below are the findings of some of these studies, which are being presented at ASN Kidney Week 2013 November 5-10 at the Georgia ...

Researchers find acute kidney injury predicts poor outcomes for dialysis patients

November 7, 2013
Two University of Cincinnati (UC) researchers, in collaboration with other investigators, have found that patients who suffered from acute kidney injury (AKI) in the two-year period prior to going on dialysis were 1.5 times ...

Intensive kidney dialysis indicates better survival rates than conventional dialysis

April 25, 2012
Patients suffering with end-stage renal disease could increase their survival chances by undergoing intensive dialysis at home rather than the conventional dialysis in clinics. A new study by Lawson Health Research Institute ...

Acute kidney injury increased for some over last decade

November 1, 2013
(HealthDay)—Over the last decade there has been an increase in the incidence of acute kidney injury (AKI), but a decrease in the incidence of AKI requiring dialysis, among elderly patients hospitalized with a heart attack ...

Overnight dialysis boosts kidney health—while reducing risk of heart disease

October 18, 2013
Receiving dialysis at home while sleeping not only improves kidney health and quality of life for people with kidney disease, it could also decrease their risk of heart disease, says new study presented at the Canadian Cardiovascular ...

Behavioral therapy provided during dialysis sessions may combat depression among kidney failure patients

October 11, 2013
Behavioral therapy provided chair-side to kidney failure patients while they're undergoing dialysis may help fight depression and improve patients' quality of life, according to a study appearing in an upcoming issue of the ...

Recommended for you

Study reveals how MRSA infection compromises lymphatic function

January 17, 2018
Infections of the skin or other soft tissues with the hard-to-treat MRSA (methicillin-resistant Staphylococcus aureus) bacteria appear to permanently compromise the lymphatic system, which is crucial to immune system function. ...

Fresh approach to tuberculosis vaccine offers better protection

January 17, 2018
A unique platform that resulted in a promising HIV vaccine has also led to a new, highly effective vaccine against tuberculosis that is moving toward testing in humans.

New study validates clotting risk factors in chronic kidney disease

January 17, 2018
In late 2017, researchers from Boston University School of Medicine (BUSM) discovered and published (Science Translational Medicine, (9) 417, Nov 2017) a potential treatment target to prevent chronic kidney disease (CKD) ...

Newly-discovered TB blood signal provides early warning for at-risk patients

January 17, 2018
Tuberculosis can be detected in people with HIV infection via a unique blood signal before symptoms appear, according to a new study by researchers from the Crick, Imperial College London and the University of Cape Town.

New study offers insights on genetic indicators of COPD risk

January 16, 2018
Researchers have discovered that genetic variations in the anatomy of the lungs could serve as indicators to help identify people who have low, but stable, lung function early in life, and those who are particularly at risk ...

Previous influenza virus exposures enhance susceptibility in another influenza pandemic

January 16, 2018
While past exposure to influenza A viruses often builds immunity to similar, and sometimes different, strains of the virus, Canadian researchers are calling for more attention to exceptions to that rule.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.