Saturday, 12 April 2014

High Altitude Dialysis

A recent report suggests that if you are unlucky enough to need dialysis, it helps if you happened to live at high altitude, say 6000' amsl

University of California Irvine Medical Center studied a national cohort of 144,892 dialysis patients with a follow-up of 801 days to examine the connection between residential altitude and all-cause mortality in these patients. The researchers found that high residential altitude, defined as 6000 feet or greater, was associated with a significant 8% reduction in all-cause mortality risk in dialysis patients compared with living at less than 250 feet.

Other studies have found similar observations, but with a larger effect being reported.

However, there are a few points to be born in mind - Patients living in higher altitudes were more likely to be white, married, on peritoneal dialysis, and receiving catheter dialysis access, compared to those on lower altitudes (less than 250 feet). They also displayed higher hemoglobin and creatinine levels, but lower parathyroid hormone levels.

Perhaps the background to these high altitude patients is just as important. It has been suggested that survival of dialysis patients at high altitude is due to the regulatory effects of hypoxia-induced factors on enzymes associated with cardiovascular risk, while increased UV light at higher altitudes, leading to higher vitamin D levels, might also be a factor.