15 Mar Chronic Kidney Disease: Study Evaluates What Happens to Patients Who Forgo Dialysis
MedicalResearch.com Interview with:
Susan P. Y. Wong, MD MS
Division of Nephrology
University of Washington
VA Puget Sound Health Care System
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Very little is known about the care and outcomes of patients who reach the end stages of kidney disease and do not pursue dialysis. We conducted a systematic review of longitudinal studies on patients with advanced kidney disease who forgo dialysis to determine their long-term outcomes.
We found that many patients survived several years and experienced sustained quality of life until late in the illness course. However, use of acute care services was common and there was a high degree of variability in access to supportive care services near the end of life.
MedicalResearch.com: What should readers take away from your report?
Response: Our study highlights how dialysis shouldn’t be the only option for treating advanced kidney disease, although it can often seem this way to patients. Our findings show that there are clinical and research programs that are working to develop approaches to caring for patients do not wish to pursue dialysis and that are making this a viable and positive therapeutic option for patients. By clarifying what the long-term outcomes of patients who forgo dialysis might be, our study findings can help patients make better decisions about whether dialysis is right for them and help clinicians with their care planning.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: The evidence to support care practices for patients who forgo dialysis is still very limited, and more research is needed to help us understand how to best care for these patients and optimize their outcomes. There also needs to be consistent and systematic approaches to surveillance of practices and outcomes for patients who forgo dialysis to support generalizability of research findings.
Wong SPY, Rubenzik T, Zelnick L, et al. Long-term Outcomes Among Patients With Advanced Kidney Disease Who Forgo Maintenance Dialysis: A Systematic Review. JAMA Netw Open. 2022;5(3):e222255. doi:10.1001/jamanetworkopen.2022.2255
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