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Dialysis initiation in nursing home residents offers poor outcomes and opportunities

ORLANDO, Fla.—Patients living in nursing homes could see the benefit of receiving dialysis therapy without having to take an ambulance ride to the nearest dialysis clinic, but survival among this population is poor.

Patients with kidney disease who reside in nursing homes cover all ages, and comorbid conditions, Eric Weinhandl, PhD, MS, said during a presentation here at the Annual Dialysis Conference. He and Allan J. Collins, MD, FACP, reviewed data from the U.S. Renal Data System files on the characteristics of the typical nursing home patients and how they receive dialysis therapy.

“The cost of hospitalizations among nursing home patients on dialysis – and the frequency – is high,” Weinhandl said. “There are about 8,000 dialysis patients in nursing homes, about 7% of the incident dialysis population.”

While most U.S. patients in nursing homes are in the 65- to 85-year-old age range, Weinhandl said, “ … 27% of this patient population is the non-elderly, between 20 to 64 [years of age].”

He added, “The largest problem is the poor survival in the elderly. Survival among nursing home patients in the first 12 months is usually 50% or less. That rate of survival is similar to patients discharged with heart failure.”

Most deaths are attributed to congestive heart failure, pulmonary edema and fluid overload. Infection control is also a major issue for the elderly because they do not have the ability to fight off disease, Weinhandl said.  by Mark E. Neumann

 

Reference:

Weinhandl ED, et al. High burden of hospitalization and related Medicare expenditures in incident dialysis patients in nursing homes. Presented at: Annual Dialysis Conference; March 3-6, 2018; Orlando, Fla.

 

Disclosures: The authors reported no relevant financial disclosures.

ORLANDO, Fla.—Patients living in nursing homes could see the benefit of receiving dialysis therapy without having to take an ambulance ride to the nearest dialysis clinic, but survival among this population is poor.

Patients with kidney disease who reside in nursing homes cover all ages, and comorbid conditions, Eric Weinhandl, PhD, MS, said during a presentation here at the Annual Dialysis Conference. He and Allan J. Collins, MD, FACP, reviewed data from the U.S. Renal Data System files on the characteristics of the typical nursing home patients and how they receive dialysis therapy.

“The cost of hospitalizations among nursing home patients on dialysis – and the frequency – is high,” Weinhandl said. “There are about 8,000 dialysis patients in nursing homes, about 7% of the incident dialysis population.”

While most U.S. patients in nursing homes are in the 65- to 85-year-old age range, Weinhandl said, “ … 27% of this patient population is the non-elderly, between 20 to 64 [years of age].”

He added, “The largest problem is the poor survival in the elderly. Survival among nursing home patients in the first 12 months is usually 50% or less. That rate of survival is similar to patients discharged with heart failure.”

Most deaths are attributed to congestive heart failure, pulmonary edema and fluid overload. Infection control is also a major issue for the elderly because they do not have the ability to fight off disease, Weinhandl said.  by Mark E. Neumann

 

Reference:

Weinhandl ED, et al. High burden of hospitalization and related Medicare expenditures in incident dialysis patients in nursing homes. Presented at: Annual Dialysis Conference; March 3-6, 2018; Orlando, Fla.

 

Disclosures: The authors reported no relevant financial disclosures.

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