| Take Charge of Your Healthcare with
My Health™ |  |
AAKP My Health™ now offers new features to help users take charge of their health care. Users can now:
· Receive appointment reminders by email
· Print emergency contact cards AAKP My Health™ is a free, unique section of the AAKP website, www.aakp.org, that provides you with online tools to be the leader in your healthcare. With AAKP My Health™, you can:
· Track your lab results
· Log your medications
· List your healthcare team members
· Prepare information for doctor visits
· Test your kidney knowledge
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| Starting Dialysis Earlier May Be Harmful for Some Patients | |
 Beginning dialysis therapy earlier in the development of advanced kidney disease appears to be associated with a greater risk of death for some patients in the following year, according to a report in the Archives of Internal Medicine. Researchers analyzed data from 81,176 patients ages 20 to 64 who began dialysis between 1996 and 2006. They assessed only patients who did not have diabetes or any other co-occurring illness besides high blood pressure.
Overall, 9.4 percent of patients died within the first year and 7.1 percent died the second year. Patients who had an early start to dialysis based on their eGFR were more likely to die in the first year than were those who started later (20.1 vs. 6.8 percent). Patients with the lowest levels of albumin also had an increased risk of death in the first year compared to those with the highest albumin levels (21 vs. 4.7 percent). Other factors associated with increased risk of death included increasing age, being black or male and having a lower body mass index, whereas having higher levels of hemoglobin, being treated in a later year, being Asian and having certain types of kidney disease were associated with survival.
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Social Support is Critical to Dialysis Patients' Health |
 Dialysis patients with little social support from friends and family are more likely to ignore doctors' orders, experience a poorer quality of life, and die prematurely, according to a study in the Clinical Journal of the American Society of Nephrology. The results suggest strong social networks are important for maintaining dialysis patients' health. Kidney disease patients on dialysis often feel stressed because they must take time away from family and friends to undergo treatments. In many cases, they may feel guilty about being ill and be reluctant to ask for support. Researchers investigated the influence of social support on patient survival, adherence to medical recommendations, and quality of life. They analyzed data on 32,332 dialysis patients enrolled in the Dialysis Outcomes and Practice Patterns Study (DOPPS). Patients answered questions related to social activities, whether they felt isolated, considered themselves burdens, and what kinds of support they received from family and dialysis staff. Patients who said that their ill health had interfered with social activities, isolated them, or created a burden to family, and who lacked family support, were more likely to die during the study period. These patients were also less likely to follow their doctors' orders, maintain dialysis, or possess physical quality of life. Staff encouragement and support did not help patients follow medical orders. The study results raise the possibility that social-support interventions may improve patient care. Such interventions could strengthen other psychosocial factors, improve survival and enhance quality of life. |
| Patients Benefit by Switching from Catheters to Arteriovenous Access |  For kidney disease patients who must undergo dialysis, experts recommend an arteriovenous blood access, preferably a fistula which is created by connecting a vein and an artery to form a long-lasting site through which blood can be removed and returned, according to a study in the Clinical Journal of the American Society of Nephrology.
Many patients become complacent with using a catheter instead - even though catheters are associated with increased infections, complications, and deaths - because they do not require advanced surgery and attachment to the dialysis machine does not require needles. A new study shows that patients who convert from catheters to an arteriovenous access have a lower risk of being hospitalized for any reason. Compared with patients who kept their catheters, patients who converted had a 30 percent lower risk of being hospitalized within one year, while patients with arteriovenous access who switched to catheters were 22 percent more likely to be hospitalized. |
| Rate of Kidney Function Decline Affects Risk of Premature Death | |
Studies that have taken a snapshot of chronic kidney disease (CKD) indicate the condition increases one's risk of premature death, but in reality, kidney disease is dynamic and changes over time. A recent study indicates that a patient who has experienced rapid kidney function decline has a higher risk of dying prematurely than a patient whose kidney function decline was mild. To come to this conclusion, the researchers studied 4,171 patients with early kidney disease, following them for approximately nine years. They found that 38 percent of the patients did not experience any kidney function decline, while 10 percent, 28 percent, and 24 percent experienced mild, moderate, and severe kidney function decline over time, respectively.
Patients who experienced severe kidney function decline over time had a 54 percent increased risk of dying compared to patients with mild kidney function decline. These findings show the rate of kidney function decline has a significant impact on a kidney disease patient's risk of dying prematurely. All patients with kidney disease have a higher risk of dying early, but rapid development of kidney disease has a poorer overall prognosis and carries an even higher risk of premature death. Therefore, physicians should carefully assess patients' change in kidney function over time and focus on strategies to protect their kidney function.
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| Why Do Some Dialysis Centers Have Higher Survival Rates? |  Characteristics such as patient engagement, physician communication, and staff coordination may help to explain why some dialysis centers achieve higher patient survival rates than others. The purpose of this study was simple: to figure out what top-performing dialysis units might be doing differently from bottom-performing units, and to translate those findings into a blueprint for action. Researchers identified many factors that may enhance survival in dialysis.
The researchers surveyed clinical staff members at 90 dialysis centers within three large dialysis organizations about center characteristics that could potentially affect patient outcomes. Nineteen unique characteristics were found to be associated with lower-than-expected mortality rates. Staff at centers with above-expected survival rates reported that their patients were more "engaged" in their own care. Top-performing centers also reported stronger physician communication skills and interpersonal relationships. The top-performing dialysis centers also had superior coordination and staff management and dietitians who were "more resourceful and knowledgeable." The study appears in the Clinical Journal of the American Society of Nephrology.
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