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Dialysis at a crossroads: 50 years later
Thomas Parker1, Raymond Hakim, Allen R Nissenson
1Renal Ventures Management, 100 Highland Park Village, Suite 200, Dallas, TX 75205, USA. tfparker3rd@yahoo.com
Clinical Journal of the American Society of Nephrology : CJASN
|December 15, 2010
Summary
Hemodialysis for kidney failure has stagnated. New strategies focusing on vascular access and fluid management may improve patient survival and reduce hospitalizations.
Area of Science:
- Nephrology
- Cardiovascular Medicine
Background:
- Hemodialysis has been a life-extending treatment for chronic kidney failure for 50 years.
- Current outcomes in the United States show stagnant survival rates and high hospitalization rates.
Observation:
- Stagnation in hemodialysis outcomes may stem from current and past treatment approaches.
- Dialysis therapy is at a critical juncture, necessitating exploration of novel strategies.
Findings:
- This article proposes new therapeutic paths for hemodialysis.
- Key areas for improvement include avoiding indwelling catheters for vascular access and controlling extracellular volume.
- Mitigating left ventricular hypertrophy and fibrosis is also emphasized.
Implications:
- Advancements in vascular access and fluid management can potentially overcome the stagnation in hemodialysis outcomes.
- These improvements may lead to better life extension and reduced disability for patients with end-stage kidney failure.
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