Dialysis may affect mobility in frail elderly with end-stage renal disease

(I was under the impression that there is no alternative to Dialysis for ESRD)

Dialysis may affect mobility in frail elderly with end-stage renal disease

Thursday, October 15, 2009 21:24 IST

Washington: Researchers suggest that before offering the treatment,
kidney specialists need to weigh which elderly patient suffering from
end-stage renal disease (ESRD) would benefit the most from either
dialysis or conservative therapies.
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Dialysis provides artificial replacement of lost kidney function,
passing a patient's blood through a machine that filters out
impurities normally captured in the organ. The treatment can be
lengthy and physically challenging for patients.

Conservative treatment, which does not involve dialysis, focus on
medicines to decrease the symptoms of the kidney failure places less
physical stress on patients and can result in a better quality of
life, particularly for patients in ESRD.

The researchers have found that elderly patients with ESRD have
multiple functional impairments, physical symptoms and a high rate of
depression, facts that require an integrated, holistic approach to the
care.

There are also increased rates of frailty, cognitive dysfunction and
geriatric syndromes such as falls and hospitalization involving elders
undergoing dialysis.

"To care effectively for these persons, we must now learn much more -
we must define who among this population will benefit most from
dialysis and who will benefit most from conservative therapy," said
the researchers.

Lead researchers Mark L. Zeidel, and Robert M. Arnold said that small
studies that examine the outcome of patients who elect conservative
therapy over dialysis suggest that mortality and quality-of-life
outcomes do not differ very much among selected patients who undergo
dialysis and those who do not.

They believe it is critical that larger studies be designed to
determine the actual benefit of dialysis for frail elders.

The study conducted over home residents on dialysis. It found poor
overall outcomes, in the first year after initiation of dialysis with
58 percent of residents dying and 29 percent having a decrease in
functional status. Only 13 percent maintained functional status.

They found that elderly patients with ESRD have multiple functional
impairments, physical symptoms and a high rate of depression, facts
that require an integrated, holistic approach to the care.

There are also increased rates of frailty, cognitive dysfunction and
geriatric syndromes such as falls and hospitalization involving elders
undergoing dialysis.
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Source:
http://www.dnaindia.com/health/report_dialysis-may-affect-mobility-in-frail-elderly-with-end-stage-renal-disease_1299443