Children on dialysis for end-stage kidney disease have a much lower risk of dying than they did 20 years ago, according to a new study published in the Journal of the American Medical Association (JAMA).
Children on dialysis have a much shorter life expectancy than adults receiving dialysis treatment. These children already face 30 percent greater risk of death compared to healthy children. Dialysis is the only life-saving therapy for them as they wait for a kidney transplant.
Researchers with Cincinnati Children’s Hospital Medical Center set out to determine if death rates had changed in these patients. Thus, they identified more than 23,000 children and adolescents younger than 21 with end-stage kidney disease who were initially treated with dialysis between 1990 and 2010. Then they reviewed deaths related to all-cause, cardiovascular events and infection.
They found that the all-cause mortality risk dropped progressively over time for both those younger than age 5 and those age 5 and older when treatment was started. They also found a decrease over time in cardiovascular and infection-related mortality in these patients. Researchers credit improved pre-dialysis care, advances in dialysis technology, and greater experience of dialysis clinicians.
Though improvements have been made in dialysis treatment, preventable problems can arise. Recently, the Food and Drug Administration (FDA) warned that the dialysis concentrate products GranuFlo and NaturaLyte made by dialysis services and products giant Fresenius Medical Care, had inadvertently been misused because instructions for use were confusing.
The products contain an ingredient that converts in the body to a substance known as bicarbonate. Elevated levels of bicarbonate in the blood can cause serious health consequences including sudden cardiac death. GranuFlo and NaturaLyte contain more of this ingredient than competitor products, which may lead to clinicians administering stronger-than-anticipated doses.
Fresenius is now facing numerous lawsuits for failing to adequately warn health care providers and patients of the serious risks associated with its products.
Source: Science Daily