SAN DIEGO, Nov. 16 /PRNewswire/ -- New data presented today at the American Society of Nephrology (ASN) conference suggest that optimizing practice patterns for treating chronic kidney disease (CKD) patients receiving hemodialysis may reduce hospitalization and allow patients to live longer. However, study investigators note there are wide variations in the practices and care indicators in dialysis units around the world.
"The Dialysis Outcomes and Practice Patterns Study (DOPPS) has been able to identify treatment factors that are modifiable and that likely can lead to longer, healthier lives for dialysis patients. This study shows that longevity and quality of life varies by region and by country," said Dr. Friedrich K. Port, principal investigator for the DOPPS.
The new data reveals an association between practices, behaviors and healthcare polices that impact survival of dialysis patients, including the following:
* Dialysis patients, on average, are 60 years of age and, in the United
States, have a life expectancy of 4.3 years after beginning dialysis.
* Laboratory values for many hemodialysis patients remain outside of
established NKF-K/DOQI(TM) clinical practice guidelines.
* Anemia control has improved significantly since the start of the DOPPS
study in 1997. In the U.S., Hemoglobin levels have increased from 10.8
g/dL to 11.7 g/dL in 2002. Patients whose hemoglobin level is within the
guidelines show improved survival rates and lower risk of being
hospitalized.
* The use of hemodialysis catheters for access to circulation during
dialysis has increased substantially in recent years and is connected
with greater risk of infections, poorer anemia control, and decreased
longevity.
* Control of phosphorus and calcium in the blood is difficult in dialysis
patients, but is important for patient survival, particularly with
regard to cardiovascular disease.
* International results on medication use revealed several opportunities
to improve longevity through increased use of various medications,
including multivitamins and aspirin, in patients with cardiovascular
disease.
"The ultimate goal of the DOPPS is to improve the longevity and quality of life for the more than 900,000 hemodialysis patients around the world," said Dr. Port, President of the University Renal Research and Education Association (URREA). "The numerous findings from the DOPPS are timely and relevant to health care providers, policy makers, and patients around the world. We are presenting numerous new and confirmatory results at this meeting and are very encouraged by the interest that has been stimulated by the DOPPS data. These findings will be key to rallying the global nephrology community around the need to better understand how to extend patients lives."
"We see the DOPPS study as having the same magnitude of impact on chronic kidney disease as the Framingham study had in the world of cardiovascular disease over the past 50 years," said Dr. Port. "The benefits for patients are already being realized and we are hopeful that our work will provide the stimulus and call to action needed to bring optimized, life-extending care to a larger proportion of hemodialysis patients."
"The overwhelming body of evidence from the DOPPS complements the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (NKF-K/DOQI(TM)) and provides a deeper understanding of best practices that can improve survival," said John Davis, Chief Executive Officer of the NKF, which represents the more than 300,000 dialysis patients in the US. "The big challenge is always educating clinicians and entrenching best practices in the day-to-day care of patients. We are very hopeful that the DOPPS data will result in driving further adoption of all eight sets of NKF-K/DOQI(TM) Clinical Practice Guidelines, as it is mainly through the pursuit of optimizing total dialysis patient care that extended patient longevity will be realized."
DOPPS Design
The DOPPS is an ongoing, randomized, prospective study based on the collection of observational, longitudinal data of hemodialysis patients at more than 300 dialysis facilities in 12 countries. The study aims to identify dialysis practices that promote longer lives, reduce hospital stays and improve the quality of life for patients. In 1996, DOPPS I was launched in seven countries and in 2002 DOPPS II was extended to include a total of 12 countries. To date, the DOPPS has collected data on more than 80,000 hemodialysis patients. Researchers observe the effects of administrative practices; anemia management; dialysis practices; cardiovascular risk; mineral metabolism; physician, nursing and technician practices; proper nutrition; available social services; and vascular access on CKD.
The Dialysis Outcomes and Practice Patterns Study (DOPPS) is coordinated by research scientists and staff of the University Renal Research and Education Association (URREA) and is supported by research grants from Amgen, Inc. and Kirin Brewery Co., Ltd in Japan. Findings presented at the ASN include data from all 12 countries. DOPPS data are representative of approximately 70 percent of hemodialysis patients worldwide.
Chronic Kidney Disease (CKD)
Chronic kidney disease affects roughly 20 million people in the U.S., resulting in kidney failure, increased risk of cardiovascular events and death; another 20 million Americans are at risk for developing CKD. In 2002, according to the National Kidney Foundation, 326,217 Americans suffered from kidney failure (the final stage of CKD) and required dialysis. This number is expected to increase to an estimated 661,330 by 2010.
About URREA
URREA is a not-for-profit foundation whose purpose is to conduct epidemiological, clinical, and economic studies of kidney and related diseases. URREA is dedicated to the distribution of clinical and economic information and analysis for use by the U.S. and international health care communities. URREA is also dedicated to the education of new investigators in the field of epidemiology and outcomes research.
Additional Resources Dialysis Outcomes and Practice Patterns Study: http://www.dopps.org/ NKF-K/DOQI(TM): http://www.kidney.org/professionals/kdoqi/index.aspx University Renal Research and Education Association: http://www.urrea.org/
URREACONTACT: Research Inquiries - Ronald L. Pisoni, Ph.D., Sr. ResearchScientist, rlpisoni@urrea.org, or Media Inquiries - Kerry Colligan, Mgr.Communications, kcolligan@urrea.org, both of University Renal Research andEducation Association, +1-734-665-4108