American Journal of Kidney Diseases report highlights need for more resources
February 6, 2019, New York, NY – A new article published today in the American Journal of Kidney Diseases (AJKD) that compared the mortality rate between dialysis patients and patients with several types of solid-organ cancers points to the need for innovations to improve survival on dialysis therapy.
The scientists evaluated a broad, population-based cohort in Canada and determined that men treated with dialysis had worse adjusted 5-year survival than men with prostate or colorectal cancers and women on dialysis had worse adjusted 5-year survival than women with breast or colorectal cancers.
“These results highlight the need to develop new approaches to improve survival on dialysis therapy and can be used to aid advance care planning for elderly patients beginning treatment with maintenance dialysis,” said one of the authors Gregory A. Knoll, MD, MSc, of The Ottawa Hospital and the University of Ottawa in Ontario, Canada.
The authors of the article, which will be available to everyone online at https://www.ajkd.org/article/S0272-6386(18)31126-0/fulltext for the next 90 days, reviewed data compiled on thousands of dialysis and cancer patients in Ontario from 1997 to 2015.
“Cancer research has resulted in many therapeutic advances over the last two decades, but, unfortunately, there have been relatively few treatment breakthroughs in kidney disease over the study period,” said the National Kidney Foundation’s Chief Medical Officer, Joseph Vassalotti, MD. “The National Kidney Foundation seeks to advance the care for people with kidney disease through innovation, research, health policy and education.”
“Although mortality on dialysis remains unacceptably high, there is cause for optimism in the fact that the death rate in U.S. dialysis patients decreased by 25 percent from 2001-2015,” said NKF’s Chief Scientific Officer Kerry Willis, PhD.
This study underscores the importance of supporting more quality research in dialysis that can lead to improvements in how to deliver this life-saving treatment both to extend the life expectancy and improve the quality of life for people requiring dialysis. It is also important to help dialysis patients maximize their overall health through enhanced education and support.
The authors of the article, titled “Mortality in Incident Maintenance Dialysis Patients Versus Incident Solid Organ Cancer Patients: A Population-Based Cohort,” are Kyla L. Naylor, PhD; S. Joseph Kim, MD, PhD; Eric McArthur, MSc; Amit X. Garg, MD, PhD; Megan K. McCallum, MPH; and Knoll.
“We hope that this study will stimulate more research and new innovations to improve outcomes and increase the life expectancy for people needing dialysis,” Dr. Knoll said.
Nearly 680,000 Americans have irreversible kidney failure, or end-stage renal disease (ESRD), and need dialysis or a kidney transplant to survive. Over 475,000 ESRD patients receive dialysis at least 3 times per week to replace kidney function. 121,000 people started ESRD treatment in 2014, of which 118,000 started dialysis.
The article, “Mortality in Incident Maintenance Dialysis Patients Versus Incident Solid Organ Cancer Patients: A Population-Based Cohort” will be available at https://www.ajkd.org/article/S0272-6386(18)31126-0/fulltext. Authors Naylor, Dr. Kim, McArthur, Dr. Garg, and McCallum are affiliated with ICES, London, Ontario; Naylor is also affiliated with the Institute of Health Policy, Management, and Evaluation; Dr. Kim is also affiliated with Division of Nephrology, University Health Network, University of Toronto; Dr. Garg is also affiliated with the Division of Nephrology and the Department of Epidemiology and Biostatistics, Western University, London, Ontario; and Dr. Knoll is affiliated with the Division of Nephrology, Department of Medicine, University of Ottawa and The Ottawa Hospital and the Kidney Research Centre and Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
About the American Journal of Kidney Diseases
The American Journal of Kidney Diseases (AJKD), the official journal of the National Kidney Foundation, is recognized worldwide as a leading source of information devoted to clinical nephrology practice and clinical research. Articles selected for publication in AJKD must adhere to rigorous standards, supporting the journal's goal to communicate important new information in clinical nephrology in a way that strengthens knowledge and helps physicians to provide their patients with the highest standard of care.
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In the United States 30 million adults are estimated to have chronic kidney disease—and most aren’t aware of it. 1 in 3 American adults are at risk for chronic kidney disease. Risk factors for kidney disease include diabetes, high blood pressure, heart disease, obesity and family history. People of African American, Hispanic, Native American, Asian or Pacific Islander descent are at increased risk for developing the disease. African Americans are 3 times more likely than Whites, and Hispanics are nearly 1.5 times more likely than non-Hispanics to develop end stage renal disease (kidney failure).
The National Kidney Foundation (NKF) is the largest, most comprehensive, and longstanding patient-centric organization dedicated to the awareness, prevention, and treatment of kidney disease in the U.S. For more information about NKF, visit www.kidney.org.