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Related Experiment Videos

Outcomes research in dialysis.

Hemant Dhingra1, Melvin E Laski

  • 1Division of Nephrology, Texas University Tech University Health Science Center, Lubbock, TX, USA.

Seminars in Nephrology
|July 3, 2003
PubMed
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The number of patients with end-stage renal disease (ESRD) is increasing globally. This review examines clinical indicators impacting dialysis outcomes and patient care for ESRD populations.

Area of Science:

  • Nephrology
  • Public Health
  • Clinical Medicine

Background:

  • Growing global prevalence of end-stage renal disease (ESRD) requiring renal replacement therapy.
  • Substantial increase in US Medicare-funded ESRD program enrollment, reaching 340,261 by 1999.
  • United States exhibits the highest ESRD incidence globally at 317 per million population.

Purpose of the Study:

  • To review the literature on clinical indicators affecting dialysis outcomes.
  • To discuss the impact of these indicators on the ongoing care of the ESRD population.
  • To identify potential targets for intervention to improve global outcomes in ESRD patients.

Main Methods:

  • Literature review of available studies.
  • Analysis of clinical indicators linked to dialysis outcomes.

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  • Examination of the impact on continuing care strategies for ESRD patients.

    • Main Results:

    • ESRD patients face significant mortality, morbidity, and reduced quality of life despite advancements in dialysis.
    • High comorbidity rates (≥3 conditions in 50% of patients) and substantial healthcare utilization (14 hospital days/year).
    • Self-reported quality of life is markedly lower in dialysis patients compared to the general population.

    Conclusions:

    • Interventions should target measurable global outcomes like mortality, morbidity, and healthcare costs.
    • Patient outcomes with demonstrated links to global outcomes are also appropriate targets for intervention.
    • Understanding the role of clinical indicators is crucial for optimizing the continuing care of the ESRD population.