Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, November 4, 1993 TAG: 9311040007
SECTION: NATIONAL/INTERNATIONAL PAGE: A-9 EDITION: METRO
SOURCE: Associated Press
DATELINE: WASHINGTON LENGTH: Medium
A National Institutes of Health panel of experts said Wednesday that these problems could be reduced by earlier and more aggressive treatment of conditions that lead to kidney failure and by longer sessions on artificial kidney machines when that therapy is needed.
The NIH panel, convened to recommend treatments for the 195,000 Americans with kidney failure, said too many patients begin renal treatment in a crisis and die before their condition can be stabilized by expert care.
"For those patients with chronic kidney failure who begin dialysis on an emergency basis, there are higher rates of treatment complications and a mortality rate as high as 25 percent," said Dr. Craig Tisher, chief of nephrology at the University of Florida school of medicine and chairman of the panel.
A federal program that guarantees treatment for patients with end-stage kidney disease as part of Medicare coverage is enrolling about 45,000 patients annually at an average cost of $35,000 per patient. As the U.S. population ages, the federal program is expected to be treating about 300,000 patients by 2000. Based on current costs, the program would then cost more than $10 billion.
In spite of this effort, the committee found, mortality rates for kidney patients remain very high. For instance, a 49-year-old patient on dialysis now has an expected life duration of 7 years, compared to about 30 years for a person of the same age in the general population.
Tisher said medical conditions that lead to kidney failure often are overlooked or inadequately treated by primary physicians.
"Kidney disease is often a silent disease," said Tisher. "It often doesn't manifest symptoms early, and a patient is not aware that they need help. They often end up on the doorstep of a doctor in renal failure."
by CNB