More than half of older dialysis patients die within a year

April 23 (UPI) -- Over half of older adults with end-stage kidney disease die within a year of starting dialysis, upending previously held beliefs about the use of the treatment, a study says.

Close to 55 percent of people older than age 65 who start dialysis treatment die within a year, according to research published Monday in JAMA Internal Medicine.

"Dialysis can seem like a magical cure for someone whose kidneys are failing, but our finding that half of older adults die within the first year after starting dialysis is sobering," Melissa Wachterman, a researcher at Harvard Medical School and the study's lead author, said in a news release.

When a person's kidneys begin to fail, dialysis cleans their blood of toxins. For some, it's used as a transition to kidney transplantation. But the majority of people on dialysis never get a transplant.

For the study, researchers pulled Medicare data from 1994 to 2014 for patients older than 65. After starting dialysis, almost 23 percent of patients died in the first month, while close to 45 percent died within six months.

The new data conflict with previous findings, many from the U.S. Renal Data Registry, a regular source for dialysis death rates. Numbers from the registry have found a 30 percent mortality rate for older adults who just started dialysis treatment.

But the registry only includes numbers for people healthy enough to receive dialysis treatment outside a hospital.

However, nearly three-fourths of patients begin dialysis inside of a hospital and some don't live to receive outpatient treatment. This makes the new findings more realistic, the researchers say.

They suggest that time-consuming dialysis might not make sense for patients who don't have long to live.

"When time is short, how you spend that time becomes even more important," Wachterman said. "Spending the better part of three days a week doing dialysis may not be the right choice for everyone and people should factor this new evidence into their decisions."

The researchers want to make patients more aware of alternatives to dialysis, such as conservative care, which manages the pain and breathing problems associated with kidney disease. While these options may cut survival time, they free patients of the burden of constant dialysis.

"We may have been painting an overly rosy picture for some patients as to what things will look like after starting dialysis," Wachterman said. "We hope this new evidence can help patients and families cope with what lies ahead and empower them to make informed treatment decisions that are most aligned with their goals and preferences."