Disability Quiz Spots Dialysis Death Risk

Kidney dialysis patients with disability may face higher risk of death

(RxWiki News) While dialysis can replace the work your kidneys used to do, it is far from a cure for kidney failure. In fact, many dialysis patients die before they can get a transplant.

Now, researchers have identified a simple quiz that may pinpoint which dialysis patients have the highest risk of death.

The quiz may help doctors better target treatment towards the patients who need it most.

"Visit your doctor regularly if you're on dialysis."

Dorry L. Segev, MD, PhD, of Johns Hopkins University, and colleagues embarked on their study with the belief that kidney failure may resemble an accelerated body-wide aging process. That is, kidney failure patients may be faced with the damage that typically happens as a normal part of aging.

With this idea in mind, the researchers used a six-question quiz - which is usually used to measure disability in the elderly - to identify dialysis patients of any age who are most at risk of death.

According to Dr. Segev, older patients have a higher risk of poor outcomes because their organ systems don't work as well as they used to. Now, there's a growing body of evidence that dialysis and kidney failure not only affect kidney function but other organ systems as well. With this evidence in mind, the researchers thought that a quiz normally used on the elderly could also apply to dialysis patients.

The researchers found that patients who needed help with at least one basic day-to-day activity - including eating, getting dressed, walking, grooming, going to the bathroom and taking a bath - were more than three times more likely to die than patients who did not need help.

"This quiz helps us identify an at-risk group that would probably benefit from closer monitoring and maybe even physical therapy to improve their functioning," said Dr. Segev.

Of the 143 dialysis patients involved in the study, 41 percent (about 58 patients) had disability - an amount higher than older adults in general.

"Measuring a dialysis patient's ability to perform activities of daily life may be an important tool," said study co-author Mara A. McAdams-Demarco, PhD, of Johns Hopkins University.

The study - which was funded by the Doris Duke Charitable Foundation - was published October 11 in the Journal of the American Geriatrics Society.

Review Date: 
October 12, 2012