The term ‘dialysis’ refers to a treatment option that is suggested for people diagnosed with end-stage renal failure. The following HealthHearty write-up provides information about the factors affecting the life expectancy or the survival rates for people who are on dialysis.
The kidneys are paired organs that filter out wastes from the blood, thereby maintaining the fluid and electrolyte balance, and regulating the composition of the blood. The term ‘kidney failure’ refers to the inability of the kidneys to perform the aforementioned functions. In case of people affected by chronic kidney disease, the kidney function gets adversely affected over a period of time. Kidney failure is divided into five stages. In the end-stage renal failure, about 85% – 90% of the kidney function is lost, and the affected person has a glomerular filtration rate (GFR) of less than 15. During this stage, dialysis or kidney transplant are suggested as the treatment options.
Though dialysis may offer a better quality of life and extend the survival, people undergoing this procedure often have multiple health concerns, which can have an adverse impact on the life expectancy. The National Institute of Diabetes and Digestive and Kidney Diseases reports the one-year survival rate for dialysis patients to be around 80%, whereas the two-year, five-year, and ten-year survival rates are around 64%, 33%, and 10% respectively.
Factors Affecting Life Expectancy
Dialysis is strictly administered to patients diagnosed with end-stage renal disease (ESRD). In some cases, patients awaiting a kidney transplant might be asked to undergo dialysis as a temporary measure. It must be noted that dialysis cannot cure kidney failure. This is only a procedure for carrying out the primary functions of fluid removal and waste removal from the human body. Dialysis is categorized into hemodialysis and peritoneal dialysis. People in the end-stage renal failure will need to undergo dialysis for the rest of their life, unless they opt for a kidney transplant.
The prognosis for a person in the end-stage renal failure depends on various factors. While dialysis can be life-saving, and there are people who live beyond the expected life expectancy, prognosis could be poor due to the associated illnesses. Though opting for dialysis may result in extended survival, when compared to people opting for conservative management, factors such as age, functional status, and co-existing medical conditions may affect the life expectancy.
According to U.S. Renal Data System, the mortality rate is twice as high for dialysis patients aged 65 and above, in comparison to the general population who have diabetes, cancer, congestive heart failure, CVA/TIA, or AMI. The condition of the patient at the time of starting dialysis does affect the life expectancy. Studies have indicated that the survival rates are lower for ESRD patients, who are 65 years and above. The median life expectancy declines with age.
Co-existing Medical Conditions
Mortality rates in dialysis patients are also adversely affected, depending on the underlying cause of kidney disease, or the co-existing medical conditions such as diabetes, atherosclerotic heart disease, congestive heart failure, peripheral vascular disease, stroke, cancer, liver disease, gastrointestinal bleeding, or lung disease. The five-year survival rates after the start of dialysis for diabetes, polycystic kidney disease, and glomerulonephritis are about 29%, 70%, and 58% respectively.
Kidney Dialysis and Quality of Life
The decision to opt for dialysis is a hard one. Dialysis can be a physically-taxing procedure, which is why, all aspects must be considered while opting for this treatment. People who opt for hemodialysis, will need dialysis sessions three times a week, with each session lasting for about four hours. Patients might feel exhausted with the routine of undergoing dialysis at dialysis centers. There are other aspects that need to be considered. For instance, the amount of fluid intake has to be restricted. Certain dietary restrictions also need to be followed. Though there are fewer restrictions on the fluid intake and diet in case of peritoneal dialysis, it has to be performed daily. There is also a risk of peritonitis. In general, dialysis is associated with symptoms such as:
❒ Hepatitis B and Hepatitis C
❒ Infections at the access point
❒ Bleeding from the access point
❒ Low blood pressure
While mortality rates for dialysis patients were consistently rising during 1980 to 2001, they have been falling since 2001. By 2008, mortality rates returned to early 1980s levels. There have been cases where patients have lived for several years, while on dialysis. Five-year survival rate for dialysis patients has improved from 29% to 34% for patients undergoing hemodialysis. It has also improved from 29% to 40% in case of people undergoing peritoneal dialysis. Despite the improvements in the prognosis, patients opting for dialysis must understand that opting for dialysis will be life-changing. The quality of life would be diminished. There’s also the option of kidney transplantation, which is a far more effective treatment option when it comes to life expectancy. As per the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the five-year survival rate for dialysis patients is 35.8%, in comparison to five-year survival rate of 85.5% for transplant patients.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.