People over 65 years of age with stage four chronic kidney disease (CKD) are more likely to die with the disease than from it, according to new research published.
University of Tasmania researcher Professor Matthew Jose and colleagues analysed linked data from the Tasmanian Chronic Kidney Disease study for all Tasmanian adults diagnosed with incident stage 4 chronic kidney disease between 1 January 2004 and 31 December 2017.
The study found people with stage 4 CKD the five-year risk of kidney failure declines with age, with the risk of death greater than that of kidney failure for those aged over 65 years.
The study also found risks of death and kidney failure for people over 65 are greater for men than women.
“For people with established kidney disease there is a high rate of death, and many do not survive long enough to need a kidney dialysis machine,” lead author Professor Jose said.
“When kidney replacement therapy pathways are well defined and supported, disease management typically focuses on dialysis or transplantation, the pathway to supportive (non-dialysis) care is less well defined.”
Currently clinical guidelines recommend that patients be referred to kidney specialists, in order to prepare for kidney failure or kidney replacement therapy.
“Clinical guidelines should recognise competing risks of death in older people with severe kidney disease, and consider holistic, supportive care, not just kidney replacement therapy,” Professor Jose said.
“Kidney disease is common in Australia, but much of it is preventable with early detection and management of kidney disease critical.”
Professor Jose is a Professor of Medicine at the University’s Tasmanian School of Medicine and the Royal Hobart Hospital.
The study, Competing risks of death and kidney failure in a cohort of Australian adults with severe chronic kidney disease, was published in the Medical Journal of Australia.