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Health researchers often scrutinize various medical treatments to determine their effectiveness, especially for older adults. One noteworthy study, published in the Annals of Internal Medicine, examined the impact of dialysis on older patients with kidney failure, revealing mixed results.
The study focused on more than 20,000 veterans, with an average age of 78, and used a simulated trial to explore survival outcomes. The results indicated that starting dialysis immediately after diagnosis only marginally extended life expectancy by about 77 days over three years compared to those who never received dialysis.
Georgia Outlaw, a 77-year-old retiree from Williamston, North Carolina, chose to forgo dialysis despite her advanced kidney disease. Her experience with relatives who had undergone the treatment, which required frequent and grueling visits to dialysis centers, influenced her decision. She expressed a desire to avoid a life tied to a rigorous medical routine that would offer minimal extension of her lifespan.
Dr. Manjula Tamura, a nephrologist at Stanford and the study’s senior author, highlighted the modest life extension that dialysis offers older patients. She noted that while dialysis does extend life, it also increases the likelihood of spending more time in medical facilities than at home.
The study also explored alternative treatments, such as conservative management, which includes managing symptoms with medications and lifestyle changes. Dr. Rasheeda Hall, a geriatric nephrologist, noted that this approach may offer a better, though potentially shorter, quality of life because it allows patients to remain more comfortable in their familiar environments.
The findings challenge the prevailing assumption that dialysis is the only viable option for kidney failure in older adults. They highlight the importance of providing patients with comprehensive information about all available treatments to make informed decisions that are aligned with their personal health goals and life circumstances.
Georgia Outlaw’s choice reflects a growing trend among older kidney patients who prioritize quality of life over length of life. Her story is a testament to the complex decisions faced by those with chronic conditions and the medical community’s evolving perceptions of treatment effectiveness and patient autonomy.
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