Is dialysis the best treatment for different ethnicities?

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Different ethnicities may benefit from different types of treatments for advanced kidney disease. mailsonpignata/500px/Getty Images
  • More than 10% of people worldwide have kidney disease.
  • Although 78% of people with advanced kidney disease opt for dialysis, it is not always a viable treatment option.
  • Researchers from the University of California at Irvine show that certain ethnic groups have higher hospitalization rates when treated with dialysis rather than conservative management.

Kidney disease affects more than 10% of the world’s populationtotaling more than 800 million people.

If a person’s kidney disease progresses to the point where one or both kidneys begin to fail, treatment options may include a kidney transplant or dialysis where a machine is used to perform waste removal functions kidneys.

Another treatment option for people with advanced kidney disease is conservative management. This treatment does not include dialysis. Instead, it focuses on addressing a person’s symptoms and quality of life.

A research team from the University of California, Irvine recently presented a study at the American Society of Nephrology Kidney Week 2022 Annual Conference showing that certain ethnic groups may have better hospitalization outcomes with management treatment. conservative rather than with dialysis.

When a person suffers from kidney disease, their kidneys are no longer able to properly remove waste products and excess fluids from the body, turning them into urine.

There are five stages to kidney disease. A person reaches stage 5 when one or both of their kidneys fail or are about to fail due to kidney damage. When this happens, a person needs to change their lifestyle to properly eliminate waste from the body.

One such lifestyle change option is dialysis. About 78% of people with kidney disease worldwide have dialysis as a treatment option.

Through dialysis, a machine replaces a person’s kidneys by pumping blood out of a person’s body, cleaning it of waste products, and pumping filtered blood back into the body. Dialysis takes place either in a hospital, dialysis center or at home.

Side effects of dialysis

Some people may experience side effects with dialysis, including:

Although dialysis is a popular treatment option for advanced kidney disease, it is not for everyone. For example, people on dialysis are at increased risk of heart failure. Previous research shows that there may be a increased risk of dementia in people on dialysis.

And research shows that dialysis can have a negative impact on a person’s quality of life.

For these reasons, people with advanced kidney disease will sometimes opt for a treatment without dialysis called conservative management. This option focuses on treating the symptoms of kidney disease through lifestyle and diet changes, medications, and support services.

Previous research shows that conservative management is a viable treatment option for the elderly with renal insufficiency. Additionally, studies show that people receiving conservative management can potentially live for years with proper support.

However, research shows that there are many misconceptions on conservative management and physicians does not always provide as an alternative for people with kidney disease.

For this study, researchers compared the hospital records of more than 309,000 people with advanced kidney disease treated with dialysis or conservative management over a 13-year period. Within this group, 55% had been hospitalized at least once.

After analysis, the researchers found that non-Hispanic white, non-Hispanic black, and Hispanic people who received dialysis had higher hospitalization rates than those who underwent conservative management.

Among these ethnic groups, people who started dialysis early when their kidneys were still at a relatively high level of functioning had the highest hospitalization rate, compared to people who started dialysis when their kidneys were at a low level. low functioning.

The researchers also found that people of Asian descent in the population group studied had a higher rate of hospitalization if they received dialysis.

However, in this ethnic group, people who started dialysis late had higher rates of hospitalization than those who started dialysis early, especially in older age groups.

Among those who reported hospitalizations, the most common reasons were:

“There is growing recognition of the importance of non-dialytic conservative management as an alternative patient-centered treatment strategy for advanced renal failure,” says Dr. Connie Rhee, Associate Professor of Medicine, Associate Professor of Public Health and Vice Chair of Clinical Research in the Department of Medicine at the University of California at Irvine and member of the research team.

“[C]Conservative management remains underutilized in the United States, which may in part be due to uncertainties about which patients will benefit most from dialysis versus non-dialytic treatment.
— Dr. Connie Rhee

“We hope that these findings and other research can help inform treatment options for patients, care partners and providers in the shared decision-making process of conservative management versus dialysis,” adds Dr. Rhee.

Medical News Today spoke with Jennifer Prescott, registered nurse and owner of Blue Water Homecare and Hospice, about the findings. She said the study results could encourage doctors to look for alternatives to dialysis in people with advanced chronic kidney disease.

“Other studies have supported the use of conservative care instead of dialysis, which has resulted in [fewer] hospital stays, had [fewer] doctor visits and less overall costs to the health care delivery system,” Prescott continued.

“In my experience, the impact of dialysis on the individual and the family can be significant, including caregiver burden, decreased quality of life, and less palliative care/hospice utilization,” a- she added.

According to Prescott, the most common misconception is that the only alternative to dialysis is neglect or death.

“I think we’ll see more research into alternatives to dialysis for the conservative treatment of advanced kidney disease,” she said.

“Research on quality of life, mortality, and relationships between race/ethnicity and age can encourage physicians and patients to choose alternatives to dialysis. This can help physicians develop models of care focused on improving outcomes and quality of life for people with chronic kidney disease.
— Jennifer Prescott, RN

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