When our kidneys don’t work properly, they might need a little help doing their job, and that’s where dialysis comes in. It acts like an artificial kidney, cleaning our blood when our kidneys can’t.
But not everyone on dialysis has the same kind of kidney problem. Some have chronic issues, meaning their kidneys have stopped working for good.
Others might have acute problems, a sudden injury that might get better over time.
The Core of the Problem
Everyone’s heard about chronic kidney diseases, usually due to long-term high blood pressure or diabetes, where the kidneys stop working over time.
Patients with such diseases usually need a lifetime of treatments or a new kidney altogether.
There’s another issue called acute kidney injury which can happen due to sudden incidents like an infection or a major surgery. Unlike chronic kidney diseases, there’s hope that the kidneys might start working again.
Treatment Equality: A Good or Bad Thing?
Researchers from UC San Francisco found something surprising: whether a person has a long-term kidney problem or a short-term one, they get pretty much the same treatment.
Even when the lab results show that those with short-term problems don’t need as much dialysis, they’re still getting it. This matters because staying on dialysis when it’s not needed can cause heart issues, infections, and more.
In this study, the doctors observed over 1,700 people with sudden kidney problems and more than 6,000 people with long-term kidney disease.
They found out that most patients, regardless of their kidney issue type, were getting similar treatments and checkups.
Also, about 10% of the people with sudden kidney problems died within three months, mostly due to the conditions that led them to need dialysis.
Of the ones who did get better, three-quarters stopped needing dialysis without any changes in treatment. This means, had the doctors paid more attention, they might have stopped the treatment sooner.
The Bigger Picture
This study is crucial as it sheds light on how similar treatments for different kidney problems can have significant repercussions.
If a person’s kidneys have started working a bit, but they continue with dialysis, it can damage the recovering kidneys even more.
It’s like trying to help someone learn to walk again but making them use a wheelchair even when they don’t need it anymore.
This might lead them to depend on dialysis for life or force them to get a new kidney if they are healthy enough for a transplant.
It also brought to light how the medical world views kidney recovery. If someone’s kidney starts working at 30% of its capability, it’s clear they don’t need as much help.
But, if the recovery is only 10% to 15%, it’s not that clear and might need careful observation and discussion with the patient about the best course of action.
The Roadblocks in Treatment Alteration
There are some challenges in altering the treatment.
When a person doesn’t need dialysis anymore, it’s not beneficial for the dialysis providers as it leaves them with an unoccupied dialysis machine and the supporting medical staff like nurses and dietitians without a patient to attend to.
For the kidney doctors, managing a patient recovering from kidney injury without dialysis is more time-consuming and has its risks compared to managing them with regular dialysis sessions.
So, there seems to be less motivation to alter or stop the dialysis treatment due to these operational and financial concerns, leading to a default preference to continue the treatment.
Conclusion
The current one-size-fits-all approach to kidney treatment, whether it’s a short-term problem or a long-term one, is concerning.
People with temporary kidney issues are being exposed to treatments that they might not need and that could even be harmful to them.
This study underscores the need for more careful and personalized treatment plans based on individual recovery progress and the potential to reduce or stop dialysis when it’s not needed anymore.
To make this a reality, we need more research to develop safe ways to reduce and eventually stop dialysis for those who are getting better, and to create a medical environment that encourages and rewards personalized patient care and recovery over prolonged treatment.
The goal should always be to do what’s best for the patient’s health and quality of life.
If you care about kidney health, please read studies about how to protect your kidneys from diabetes, and drinking coffee could help reduce risk of kidney injury.
For more information about kidney health, please see recent studies about foods that may prevent recurrence of kidney stones, and eating nuts linked to lower risk of chronic kidney disease and death.
The research findings can be found in the Journal of the American Society of Nephrology.
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