Navigation Links
Early intervention dramatically improves outcomes for new dialysis patients
Date:10/18/2007

Washington, DC (October 16, 2007) A program of education, close medical follow-up, and self-empowerment for patients with end-stage renal disease (ESRD) newly starting dialysis, reduces complications and improves outcomesincluding significant reductions in mortality and hospitalization rates, reports a study in the November Clinical Journal of the American Society of Nephrology.

The researchers initiated a structured quality improvement program, called RightStart, for ESRD patients within their first two weeks and continuing for up to three months of starting dialysis. "This program for new patients has shown itself to dramatically improve outcomes, when compared to a control group that did not receive the intervention," comments Dr. Raymond Hakim of Fresenius Medical Care in Brentwood, Tenn.

"The goal of this research was to implement a patient care strategy that focused on improving clinical outcomes in the first 90 days of hemodialysis, through intensified medical, nursing, and dietary focus and empowerment of patients to influence their own health," Dr. Hakim explains. The program included one-on-one time with nurses, who provided an educational program focusing on patient self-management.

Because new patients are often malnourished, a key emphasis was nutrition teaching, especially the need for adequate amounts of protein and calories. Dietary restrictions were introduced only as needed for the individual patient. Each patient was assigned to a case manager, who actively identified and addressed any medical problems developing in the first weeks and months on dialysis, along with the multidisciplinary team.

The study tracked survival, hospitalization rates, and other outcomes for 918 patients participating in RightStart. Outcomes were compared with those of 1,020 new dialysis patients at clinics not using the RightStart program. "It is important to note that the ESRD community provides excellent care to dialysis patients overall," says Dr. Hakim. "However, because new dialysis patients have special needs, they require intense and focused care to improve their outcomes further."

After three months, patients who went through the RightStart program had better nutrition, as reflected by levels of albumin in the blood; and less anemia, as indicated by the hematocrit level. RightStart patients also improved their scores on tests of knowledge regarding ESRD and its treatment and on quality of life and mental health scores.

"This result may be an indication that the program had a positive impact on the depression that is common among dialysis patients, as they experience a life changing event," says Dr Hakim.

In the year after starting dialysis, RightStart patients spent fewer days in the hospital: an average of 7.2 days, compared to 10.5 days for patients not receiving RightStart.

RightStart was also associated with nearly a one-half reduction in mortality rate: 17 per 100 patient-years, compared to 30 per 100 patient-years in the comparison group. For individual patients, RightStart reduced the risk of death in the year after starting dialysis by about 40 percent. "Such results speak for themselves," Dr. Hakim says. "We are actively expanding the program, and making program changes to best meet the patients' needs, based on feedback from the patients and the outcomes data."

For patients starting dialysis, the mortality rate is "alarmingly high"about double the rate in patients who have been on dialysis longer than 90 days, according to Dr. Hakim. In designing the RightStart program, the researchers hoped to address some of the reversible risk factors contributing to this early mortality, such as nutrition, anemia, dialysis dose, and patient empowerment. "These new patients have special needs and require more intense focus during the early period of treatment," says Rebecca Wingard, RN, MSN, CNN, Vice-President of Quality Initiatives of Fresenius Medical Services and coordinator of the RightStart program.

Dr. Hakim also calls for expanded efforts to detect, educate, and treat patients in the earlier stages of kidney disease, before dialysis is required. "The lack of payment coverage by Medicare for patients less than 65 years old is a major impediment to providing such patients with timely education and preventive measures."


'/>"/>

Contact: Shari Leventhal
sleventhal@asn-online.org
202-416-0658
American Society of Nephrology
Source:Eurekalert

Related medicine news :

1. Gene linked to early puberty in girls
2. Cancer drugs in development nearly doubled since 1995
3. Nearly all asthma deaths preventable
4. Ductal lavage may detect early breast cancer
5. Doctors advice early anemia tests
6. Heart disease threat starts early in life for Diabetics
7. Early detection of prostate cancer
8. Early detection of heart attack
9. Early puberty linked to nutrition
10. Exercise to Prevent Early Breast Cancer
11. Drug Found To Bring Relief For Individuals With Early Parkinson’
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:3/27/2017)... ... March 27, 2017 , ... The Anaheim Hills office ... First National Capital has added 10 new sales professionals over the past 6 months ... by 15 additional new hires over the course of 2017. , “This new ...
(Date:3/27/2017)... Orange, Texas (PRWEB) , ... March 27, 2017 ... ... celebration at the GTEC Orange facility from 8:00am-10:00am on Monday, April 3rd to ... giveaways and will be an opportunity for area-residents to celebrate two great years ...
(Date:3/26/2017)... ... March 26, 2017 , ... Local physician Dr. Justin ... a prestigious award honoring the top influencers on RealSelf—the most trusted online destination ... doctors and clinics. , In 2016, more than 82 million people visited RealSelf ...
(Date:3/24/2017)... ... March 24, 2017 , ... Vighter ... the same time by providing Prehospital Trauma Life Support (PHTLS) course scholarships to ... premier prehospital trauma education developed in cooperation with the American College of Surgeons ...
(Date:3/24/2017)... ... ... The Radiology Business Management Association (RBMA) has named the nine winners ... year, are among the most prestigious in radiology marketing because a panel of radiology ... recognize achievements in both large budget (over $5,000) and small budget (under $5,000) campaigns. ...
Breaking Medicine News(10 mins):
(Date:3/27/2017)... BOSTON , March 27, 2017 ... pharmaceutical company and Paratek Pharmaceuticals, Inc. (Nasdaq: PRTK), ... commercialization of innovative therapies based upon tetracycline chemistry, ... sarecycline for the treatment of moderate to severe ... Sarecycline is a once-daily, oral, narrow spectrum tetracycline-derived ...
(Date:3/27/2017)... 2017  Impax Laboratories, Inc. (NASDAQ: IPXL)today announced that ... Bisaro as Impax,s President and Chief Executive Officer ... 27, 2017. Mr. Bisaro will succeed J. Kevin ... Chief Executive Officer since December of 2016. ... experience, Mr. Bisaro, 56, is an accomplished global business ...
(Date:3/27/2017)... 27, 2017  PhaseRx, Inc. (NASDAQ: PZRX), a ... liver diseases in children, today reported financial results ... December 31, 2016 and provided an update on ... to make progress during the fourth quarter of ... our non-human primate safety study, and with our lead ...
Breaking Medicine Technology: