Early Dialysis Treatment Increases Mortality Risk

Patients who begin dialysis earlier in the development of their renal disease have a higher risk of death in the following year than patients who start later, according to a study in the Archives of Internal Medicine.

Researchers at the William Jennings Bryan Dorn Veterans Hospital and the University of South Carolina reviewed United States Renal Data Systemfrom 81,176 non-diabetic patients between the ages of 20 to 64 who began dialysis between 1996 and 2008.

The study "raises a concern that hemodialysis may be providing more harm than benefit," says Steven Rosansky, MD, principal author of the report.

Findings show that patients who had an early start based on their estimated glomerular filtration rate (eGFR) were 10.6% more likely to die in their first year of treatment compared with patients who started treatment later.

The authors say that the higher death rates may reflect a practice pattern in which renal disease practitioners now start dialysis earlier in the course of patients' disease process in order to thwart nonspecific symptoms, such as fatigue, anorexia, nausea, symptoms associated with low serum albumin.