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More frequent dialysis improves lives, study finds
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CTV.ca News Staff
Date: Sat. Jan. 22 2011 5:32 PM ET
For the 38,000 or so Canadians living with kidney failure, only dialysis three times a week keeps them alive. But a new study finds that dialysis every day, for a shorter period, seems to greatly improve quality of life.
The frequent dialysis idea has been suggested before, but has never been widely adopted. This new study in the New England Journal of Medicine may change some minds.
According to statistics released earlier this week, the number of Canadians living with kidney failure has more than tripled in Canada in the last 20 years. About a third of the cases are caused by diabetic kidney disease, while another 15 per cent are attributed to renal vascular disease.
Other reasons for kidney failure include autoimmune diseases such as lupus, and polycystic kidney disease.
Since 1965, the only way to keep kidney failure patients alive is through dialysis three times a week, for four hours at a time. But patients have long complained that while dialysis lets them survive; they still feel continually exhausted. That's what Ollie McKelvey remembers feeling.
"Technically, I lived to dialyze," she told CTV News. "I was just surviving."
But McKelvey recently took part in a study of a new program that had patients undergo dialysis more often but for shorter bursts: two hours a day, six days a week. McKelvey says the new approach changed her life.
"I found myself after the first week with a lot more energy, and just feeling human again," she says.
Dr. Rita Suri from the division of Nephrology at the University of Western Ontario took part in the study and says her research team found that more frequent and shorter dialysis treatment improved the quality of life and survival rates of patients.
Patients showed improvements to their heart function, which is often compromised during kidney failure, and improvements to their blood pressure. What's more, most receiving the more frequent dialysis reported feeling much better overall.
"I was quite surprised as to the magnitude of the change that patients felt significantly better," says Suri.
"Patients on frequent dialysis are able to walk better, have fewer symptoms, and able to do their day-to-day activities a lot better."
Doctors think more frequent dialysis acts better because it replicates what it's like to have a real kidney.
Previous research has also come out in favour of more frequent dialysis. And yet, most kidney patients are still treated according to the traditional schedule of three times a week. The problem, it seems, comes down to cost. Standard dialysis costs about $60,000 per patient per year. Doubling the frequency would double the cost.
Still, some doctors are trying to persuade provinces to expand dialysis services to offer more frequent treatments to more patients either in hospital or at home, noting that it will lead to lower health care costs down the line.
"We can improve the probability of survival with more frequent dialysis," Dr. Robert Lindsay of the Lawson Health Research Institute in London tells CTV. "This is a major thing."
More importantly, says Lindsay, is the quality of life benefits. He notes that most of the patients who received the more frequent dialysis begged his research team to let them stay on the program and not return to standard dialysis after the study was over.
"I didn't want to because I felt so much better," says McKilvey.
In fact, McKilvey decided to learn how to perform dialysis on herself at home where she now does it every day, vowing she'll never return to dialysis the old way.
With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip
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Now we should be politically correct in paying homage to these feminists by dropping the "miss" as if that is somehow derogatory?? ..... It amazes me on how trivial the causes are that people will devote their life to. They obviously "Miss" the point to life.
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