The elderly seem to depict some degree of declivity soon after they start dialysis. Although dialysis is perhaps one of the world’s most renowned medical development, nursing home individuals and patients who undergo dialysis in hopes of treating any sort of kidney disease showed sustained and evident declivity in their mere ability to perform basic activities. Joe Cosgrove has previously covered the topic of dialysis from different angles; however, it is important to mention the possible complications of starting dialysis in later stages of life.
According to a study, patients with end-stage renal disease worsened within three months soon after starting the treatment: A year after starting the treatment, almost 60% of patients in the aforementioned study passed away, and only 12% still manage to have a decent life—at the same level—as they did prior to undergoing dialysis. In short, and resorting to the findings, although dialysis has been linked to extending the lives of patients and individuals at nursing homes, it does not, however, seem to bring back the kidneys to their initial functional status. The elderly and nursing home residents under dialysis are clearly open to suffering a sustained and evident decline in their kidneys, which also raises the question about whether it does increase the rate of mortality.
An increasing number of elderly individuals with end-stage renal disease in America are starting dialysis: nursing home individuals account for almost 5% of new end-stage renal disease patients and almost 12% of them are above the age of 75. Although dialysis is a viable treatment for individuals with renal disease—at least to some extent—, the benefits and the perks commonly associated with the treatment seem to be uncertain in elderly patients. According to the study, the rate of mortality in the first year soon after starting the treatment surpasses the 35% among patients older than 75 years of age and surpasses 55% among those individuals older than 85 years of age. Additionally, the alleged benefits on the quality of life and the extent to which the treatment seems to extend the patient’s lifespan, especially in the elderly, are still to be determined.
Researchers and physicians gathered information from a national databank of patients currently undergoing dialysis with that from a national databank of nursing home and elderly patients to identify up to 3,700 different individuals who started the treatment between 1998 and 2000. The functional performance of the subjects was initially measured using a monthly-based scale; however, researchers deemed more suitable a 3, 6, 9 and 12 months scale to measure the alleged effects of the treatment on nursing home patients. After assessing the findings, the scores were compared to a previous assessment made soon before they started the treatment.
The period before and after the beginning of the treatment is definitely the riskier stage, for the vast majority of subjects and patients have increasingly tough conditions, and many end up passing away in the following months.
Efforts to offset the risk commonly associated with the treatment, and efforts to make special emphasis on the goals of actually improving the quality of life of the patients ought to be addressed during this period rather than after individuals have started to undergo the treatment. Be that as it may, these findings are not 100% conclusive, for the lack of a control group may have resulted in the inevitable misinterpretation and underestimation of the functional declivity that occurs after the beginning of the treatment. Nonetheless, many physicians and clinicians assume that starting a somewhat conservative therapy is basically a death sentence for all those nursing home patients and the elderly; however, they also acknowledge that there have been small studies that suggest that both mortality and the aftermath of the treatment is quite similar in both demographics, and even in those elders who start the treatment and those who do not.
Prior to starting dialysis, the study concludes, nursing home patients and elderly individuals must acknowledge the real benefits of starting the treatment at such age, and they must be informed about the possibility of choosing a different approach aside from dialysis, for the risk, in light of the findings of the study is quite high. According to a recent survey, almost 95% of patients irrespective of their age and their families want to be given clear and concise information about the benefits of starting the treatment and whether or not their lifespan will be extended. As mentioned in previous articles, nephrologists and physicians must discuss these issues with their patients, for there is a really high percentage of clinicians who never address the possibilities their patients have at hand. Providing the elderly with precise information may mark the difference between having a good end or making it a nagging, excruciating, time.
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