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VA RESEARCH: MORE KIDNEY DIALYSIS ISN'T BETTER --

The seven-year study found that six dialysis treatments

a week were no better than three treatments.

For more about VA research, use the VA Watchdog search engine...click here...
http://www.yourvabenefits.org/sessearch.php?q=va+research&op=ph

Story here... http://www.pittsburghliv
e.com/x/pittsburghtrib/news/health/s_575020.html

Story below:

-------------------------

More kidney dialysis isn't better, study reports

By Allison M. Heinrichs
TRIBUNE-REVIEW

More intensive treatment for kidney failure does not have any added benefit, according to a large clinical trial led by a Pittsburgh nephrologist.

The findings, which will be reported next week in the New England Journal of Medicine, are expected to have a wide impact on care for thousands of patients and change an expensive trend toward more intensive therapy.

"There are between 40,000 and 90,000 patients with acute renal failure that require dialysis in the United States every year," said Dr. Paul Palevsky, lead author and chief of the renal section at the VA Pittsburgh Healthcare System. "The increased costs of treatment would be somewhere on the order of $100 million to $250 million every year if everyone used the intensive therapy.

"Imagine the health care that could be provided by not spending that money on an approach that actually doesn't improve outcomes," said Palevsky, a University of Pittsburgh School of Medicine professor.

Acute kidney, or renal, failure occurs when the kidneys shut down, leading to a dangerous build-up of fluids and waste. Regular dialysis treatments take over the function of the kidneys.

Palevsky's seven-year study, sponsored by the Department of Veterans Affairs and the National Institutes of Health, included 1,124 critically ill patients at 17 VA hospitals and 10 university hospitals. The large number of patients at many sites was necessary to account for the numerous reasons patients go into kidney failure.

Though the study found that six dialysis treatments a week were no better than three treatments, Palevsky said that correct dosage was important.

A simple blood test done after the treatment tells doctors if the dosage of dialysis should be adjusted, but less than a quarter of the hospitals Palevsky surveyed regularly did the blood tests. He said that should change as new machines are created that automatically do the test.

Dr. Paul Schmitz, a professor in the St. Louis University School of Medicine, cautioned that officials should not take the study results and create a blanket standard of care for renal failure.

"You'd hate for someone to say, 'Gosh, I'm not going to do this treatment daily because of this one study,' " said Schmitz, who did not participate in the study. "I hope that people consider all the variables of each patient's illness, and then determine the best treatment plan."

The findings likely will reverse a trend toward more intense treatment, said Dr. Sevag Demirjian, a nephrologist at Cleveland Clinic, one of the sites involved in the study.

"It will have a high impact in that regard," he said. "The results of this study are a surprise to the medical community at large."

Allison M. Heinrichs can be reached at aheinrichs@tribweb.com  or 412-380-5607.

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posted by Larry Scott
Founder and Editor
VA Watchdog dot Org

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