For some individuals with advanced kidney disease, dialysis may not be the optimal treatment strategy for their condition, and these patients may be better served with conservative non-dialytic management that focuses on quality of life and symptom control. Investigators recently examined the differential impact of conservative management vs. dialysis on hospitalization outcomes across varying racial/ethnic groups in a large national cohort of patients with advanced kidney disease. The research will be presented at ASN Kidney Week 2022 November 3–November 6.
In this study, the investigators compared hospitalization rates among 309,188 patients with advanced kidney disease who were treated with conservative management or dialysis over the period of 2007–2020. During follow-up, 55% of patients had 1 or more hospitalizations, and the most common causes of hospitalization in both groups were related to congestive heart failure/fluid overload, respiratory problems, or hypertension.
In Non-Hispanic White, Non-Hispanic Black, and Hispanic patients, patients on dialysis had higher hospitalization rates than those who received conservative management, and patients who started dialysis early (transitioned to dialysis at higher levels of kidney function) demonstrated the highest rates across all age groups when compared with those who started dialysis late (transitioned to dialysis at lower levels of kidney function) or were treated with conservative management. Among Asian patients, those on dialysis also had higher hospitalization rates than those receiving conservative management, but patients who started dialysis late had higher rates than those on early dialysis, especially in older age groups.
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