Mount Sinai specialist promotes home dialysis

A recent article in New York Daily News covers home dialysis and the advantages for the patient.
"We now have the technology to deliver dialysis at home, an approach that has better outcomes for patients and is cheaper,” says Dr. Jaime Uribarri of Mount Sinai Hospital."

According to the report, out of approximately 400,000 Americans on dialysis, fewer than 30,000 of them across the country receive peritoneal dialysis, the most common form of home dialysis. Although home dialysis might sound extremely technical, just about anyone willing to participate in their own care can be trained to do it. And studies have shown that hemodialysis (the main dialysis centre treatment) and peritoneal dialysis are equally effective.

So what's stopping you from trying home dialysis?

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Number of patients may affect YOUR health

There are many factors affecting your health if you have chronic kidney disease and need dialysis.
Just how busy your kidney specialist is may affect your health!

Dialysis patients receiving treatment from kidney specialists with a higher patient caseload have a greater risk of dying prematurely than those receiving care from specialists with a lower caseload, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). The study is the first of its kind to examine the association between nephrologist caseload and mortality risk in a large urban US setting.

It seems logical to me that a specialist who has to see two or three times as many patients than the average must be giving each one less time, and one who sees 66% or 50% of the average can be giving each one more time. Hence it should come as no surprize when this was reported.

But scientists never just assume, they should always check. So a group from University of California Irvine Medical Center investigated whether or not those with a high work load had more than the average risk of patients suffering premature death, and whether those with a lower number of patients lead to a better survival rate.

Among the major findings:
• Nephrologists whose dialysis patients had the best survival had a significantly lower patient caseload than nephrologists whose patients had the worst survival.
• For every additional 50 patients cared for by a nephrologist, patients had a 2% higher risk of dying during the study period.

You can read the abstract online.