I’m reading the January NephSAP on primary care for the working nephrologist

There is some great stuff in there. This line on the futility of cancer screening among dializers struck me as particularly interesting:

[Kajbaf et al.] calculated the maximum increase in life expectancy (for a 60-yr-old woman) from routine Papanicolaou (Pap) testing and mammography to be 3 and 2 days, respectively.

Wow. (Ref PDF)

I feel like dialysis is always geting beat up over the high yearly mortality rate, and admittedly it is high. So it was interesting to see this table of some other conditions and there associated mortality. I didn’t realize dialysis had such familiar company.

3 Replies to “I’m reading the January NephSAP on primary care for the working nephrologist”

  1. What is this? This is about a hip fracture at the age of 80! That is already over the live expectancy of every man or woman. So 5.4 years is very good. Dialysis at 65 means that the normal life expectancy is about 9 years, in that light 4.6 is short. But people getting on dialysis usually have a history of illness. A hip fracture can happen to anyone. This is statistical nonsens in my opninion.

  2. Actually the life expectancy for some one 80 years old is 8.9 years (9.5 for women and 7.9 for men) (Amer Fam Phys Dec 15, 2008) so 5.4 years represents a loss of half their remaining life span. Pretty bad. At 65 the life expectancy is 18.4 years (same ref) so dialysis is worse.

    What I was surprised about was that some other conditions that are not treated with nearly as much dread as dialysis result in similar life expectancies.

    Additionally hip fractures do not just happen, but are associated with a number of other conditions (osteoporosis, hyperthyroidism, mal absorption) and medications (benzos, anti-hypertensives) prescribed for conditions. Post fracture outcome is highly dependent on pre-morbid conditions. (http://bit.ly/cUtVTX)

  3. This nephsap discusses using breast MRI, which I find interesting, since I can order it pretty close to never in my dialysis patients.

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