Kidney Patient's Age, Health Should Guide Treatment

Hemodialysis or peritoneal therapy are dialysis options, study says

MONDAY, Dec. 29, 2008 (HealthDay News) -- One type of treatment does not fit all kidney disease patients in need of dialysis, a new study says.

The report, published in the January issue of the Journal of the American Society of Nephrology, finds that factors such as age, general health and long-term need should be considered before putting a patient on hemodialysis or peritoneal dialysis.

The new research, by a team from Queen Elizabeth Hospital in Adelaide, Australia, found younger patients without other medical conditions have a better survival rate on peritoneal dialysis over a period of less than a year, while others, especially those needing long-term treatment, may do better with hemodialysis.

In hemodialysis, a patient's blood flows directly through a filter to remove waste and extra fluids, then the clean blood goes back into the body. With peritoneal dialysis, a dialysis solution is put in a catheter that fills the patient's abdomen, and this solution sucks in the blood impurities through the abdominal cavity for draining and disposal.

Both types of dialysis are effective, though it has never been clear if one better prolongs the patient's life. Which dialysis a patient receives usually depends on factors such as quality of life, patient satisfaction and practice expertise.

The study reviewed information on more than 25,000 people in Australia receiving dialysis for at least 90 days. Overall, those receiving peritoneal dialysis at day 90 had a much better survival rate for up to a year, but the vast majority of these patients were younger than age 60 and without other medical conditions.

This survival advantage disappeared after a year, with the mortality rate increasing for those on peritoneal dialysis at day 90 if they received 12 months or more of treatment.

"Our data suggest caution in the use of peritoneal dialysis in many patients, particularly when this therapy is continued beyond one to two years," the study's authors wrote. They also called for randomized clinical trials to definitively determine which type of dialysis treatment patients should receive.

More information

The U.S. National Kidney Foundation has more about dialysis.

SOURCE: American Society of Nephrology, news release, Dec. 17, 2008
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