Better CKD Care May Cut First-Year Dialysis Mortality

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NASHVILLE—Patients who enroll in a structured CKD program that provides pre-dialysis interventions may improve their survival in the first year after starting dialysis, data suggest.

Joel M. Topf, MD, of St. John Hospital & Medical Center in Detroit, and his collaborators studied 172 patients who received care at a dedicated CKD clinic. The clinic, also located in Detroit, emphasizes patient education, treatment of CKD complications, and preparation for dialysis and transplantation.

The patients had a mean age of 62 years; 16% had fistulas for dialysis access. The investigators retrospectively matched the CKD clinic databases to the dialysis database maintained by DaVita so they could track the dialysis outcomes of patients who transitioned from the CKD clinic.

Of the 172 patients, 14 (8.1%) received a kidney transplant and 22 (12.8%) died in the first year. By comparison, the first-year mortality rate for dialysis patients in the federal government's Renal Network 11 (which includes Michigan and four other states) was 22.6%.

The length of time patients were enrolled in the CKD clinic did not influence mortality or biochemical outcomes while on dialysis.

The investigators noted that they have not yet analyzed the effect of specific interventions on survival.

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