The authors of the study point out that because there was no control group, they could not conclude that dialysis caused the observed functional decline. This was a retrospective look at 3702 nursing home residents starting hemodialysis between 1998 and 2000 who had at least one measurement of functional status prior to the initiation of dialysis.
The editorialists write: "Prior to the initiation of dialysis, elderly patients must be informed about its modest benefit in their age group and the possibility of conservative therapy that does not involve dialysis." So, although dialysis will prolong life in this patient population it does not seem to lead to an improvement in functional status we would have hoped to have seen.
1 comments:
One of the major problems in nursing homes that provide care for dialyzors is that there is, often,a lack of communication between the dialysis unit and the SNF. The dialysis unit provides detailed information on diet, fluid restriction, etc., and, many times, more, than not, the SNF does not carry through with that which the dialysis unit communicated. Further, many staff in SNFs are not trained to take care of a dialysis patient, especially post dialysis. But, again, a major problem, imho, is dietary restrictions.
Roberta Mikles, RN
Advocates4QualitySafeCare
www.qualitysafepatientcare.com
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