On one hand, having the dialysis is a good thing, because it keeps them alive. On the other hand, dialysis is very difficult on the body and people often take at least a day to get over the exhaustion brought on by the treatment.

For people who are able to work or go to school, having dialysis digs into their productive time, their valuable time. So, is doing dialysis at night the answer and does it make a difference to the body if it’s done at night? “Maybe” and “yes, but in a good way,” seem to be the responses, following a study in the United Kingdom. Its results were published recently in the Clinical Journal of the American Society of Nephrology (CJASN).

Some clinics in the UK were offering a night schedule of dialysis, which allowed patients to sleep through the treatment, rather than sitting in a clinic for between three and six hours at a time. These clinics set the dialysis for six hour or more sessions, overnight, three times per week.

For 10 years, researchers studied patients who underwent dialysis with the more traditional schedule and 146 night-time schedule patients.

What they found was that only one-third of the night-time scheduled patients stuck with it. For personal reasons, the remaining went back to the traditional day-time treatments. The changes weren’t done for medical reasons.

Of those who chose to stay with the night-time dialysis, the results found that in some ways, they did better than their day-scheduled peers. They (the night-timers) had less urea in their blood, which is what is being removed through the dialysis, and they were less likely to be anemic. What is interesting is that these findings add to earlier studies that found overnight dialysis lowered blood pressure, as well as what doctors call premature death.

In addition to the ability to keep a lifestyle a little more “normal,” night-time dialysis would free up spots for others during the week, perhaps making it easier to schedule patients for their treatments.

Of course, there are likely to be drawbacks. Night-time stays could play havoc with home life or touch on other issues. But, if the option is there, this could be a good solution for many people.

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Image: Stock.xhcng

Post from: Blisstree

Overnight Kidney Dialysis Possible

Diabetes is hard on anyone, but the elderly have an especially difficult time because of the maintenance required to keep the disease in check. Now, a new study suggests that elderly diabetics also have a “higher level of residual renal function when they start dialysis,” which means more are starting dialysis than ever before. In addition, they generally need to start it earlier than non-diabetic patients.

Also, the “proportion of deaths from infection was significantly increased in diabetics (12.8% vs. 9.8% of deaths).” These scary numbers mean that diabetics have to be that much more diligent about caring for themselves, and in talking with their doctor about options before complete kidney failure takes over the body.

Image: MorgueFile.

Post from: Blisstree

Elderly Diabetics and Kidney Failure

Researchers found that 16 percent of these patients reported refusing one or more medical or surgical interventions recommended by their physician. The most frequently refused interventions were cardiac catheterization and surgery, with refusal rates of over 10 percent. Other interventions refused included chemotherapy, radiation, intubation, dialysis, and transplantation. Hospitalization was rarely refused.

I can not count the amount of times I sent a very elderly, frail, compromised, extremely sick and helpless patient off to open heart surgery, let alone stress tests and catheterizations. And what I really wanted to do was say, “You are the boss of yourself. You make the final decisions and can say no to anything you want to. If you were my Grandfather, I would say don’t do it”. But I don’t, at least not for the most part.

What do you think about the quality versus quantity? And what do you think about getting second opinions and saying no to physicians? Would you feel comfortable questioning a clinician? I am always amazed at how patients hold them up high and feel like they have no say in the situation. When it should be them who are being held way up high. Be your own advocate. Don’t you think?

via Science Daily

Post from: Blisstree

Refusal Of Cardiac Procedures By The Elder Population Common