Dialysis is a medical treatment that supports individuals experiencing kidney failure, a condition where the kidneys can no longer effectively filter waste products and excess fluid from the blood. This life-sustaining therapy takes over the functions of failing kidneys, removing toxins and balancing mineral levels in the bloodstream. Many individuals live for numerous years while receiving dialysis, and advancements in care allow for extended, fulfilling lives.
General Outlook on Life Expectancy
The average life expectancy for individuals undergoing dialysis typically ranges from 5 to 10 years. However, many patients have successfully lived on dialysis for 20 or even 30 years. For patients starting dialysis, the 1-year survival rate is around 88%, improving to 70% at 3 years and 52% at 5 years. While the median survival time on dialysis is approximately 5 years, survival rates have improved due to ongoing advancements in medical treatment and patient care. These figures represent general trends, and individual outcomes are influenced by various factors.
Influential Factors on Longevity
Several medical and lifestyle elements significantly influence longevity on dialysis.
Age
Age plays a considerable role, with younger patients generally experiencing longer survival times compared to older patients. Individuals under 50 starting dialysis have a 95% 1-year survival and over 50% 10-year survival. Those over 80 see an 80% 1-year survival and 8% 10-year survival.
Pre-existing Health Conditions
Pre-existing health conditions, or comorbidities, also impact longevity. Heart disease, diabetes, and high blood pressure are common among dialysis patients and affect outcomes. Cardiovascular disease is a frequent cause of death, and diabetes contributes to early mortality. The number and severity of these conditions influence prognosis.
Type of Dialysis and Adherence
The type of dialysis received can also influence outcomes. Some studies suggest comparable results between hemodialysis and peritoneal dialysis, though one report indicates a slightly better adjusted survival rate for peritoneal dialysis patients over 3 and 5 years. Patient adherence to the prescribed treatment regimen is also important. Consistently attending sessions, taking medications, and following medical advice improve outcomes and overall health.
Nutritional Status
Nutritional status is another determinant of survival for individuals on dialysis. Maintaining a proper diet and preventing malnutrition are important, as protein-energy wasting is associated with increased illness and mortality. Inadequate intake of protein and energy can lead to malnutrition, emphasizing the need for sufficient calorie and protein consumption. Early diagnosis and management of kidney disease before dialysis can positively influence overall health and extend longevity.
Daily Life and Well-being
Living with dialysis involves adapting to practical aspects and focusing on well-being.
Common Symptoms
Patients often experience fatigue and itching, which healthcare teams manage. During sessions, some may experience a drop in blood pressure, leading to nausea, headaches, or cramps; these often lessen with consistent treatment. For peritoneal dialysis patients, infections like peritonitis are a complication requiring careful management.
Dietary and Fluid Restrictions
Dietary and fluid restrictions are part of daily life for dialysis patients. Most on hemodialysis limit fluid intake to prevent fluid overload, which causes swelling, high blood pressure, and breathing difficulties. Managing thirst can be aided by limiting sodium, consuming cold liquids, using ice chips, or sucking on hard candies. Dietary guidelines involve regulating protein, sodium, potassium, and phosphorus intake, often focusing on higher protein.
Lifestyle and Emotional Aspects
Dialysis requires lifestyle adjustments, impacting daily routines, work, and social life due to treatment time. Many patients maintain routines, work, and travel with planning.
Emotional well-being is important. Depression affects 10-30% of dialysis patients, and anxiety up to 45%. Patients may experience shock, denial, anger, sadness, or worry. Self-care, hobbies, and physical activity support mental health.
Support Systems
Support systems are important for navigating life on dialysis. Family, friends, and the healthcare team—including nephrologists, nurses, social workers, and dietitians—provide medical, financial, emotional, and practical support. Connecting with support groups offers valuable information and community. Patients are encouraged to take an active role in their care, working with their healthcare team to tailor treatment plans.