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Study: Treatment plans for kidney failure should consider cause and circumstances of disease

One size seldom fits all, so it's not surprising that one treatment regimen may not suit all patients with the same condition. Now, a new study of end-stage kidney failure shows the importance of taking factors like cause and circumstances of a patient's disease into account when designing a treatment plan.

The study (subscription required) began when Stanford nephrology fellow Michelle O’Shaughnessy, MD, noted that patients with end-stage kidney-failure usually received the same generic treatment plan (dialysis or a kidney transplant), even though there are different causes of the disease and a patient's condition can progress to kidney failure via many different routes.

As described in our press release, kidney disease is often caused by diabetes or hypertension, but it can also be caused by glomerular disease, a condition with many distinct subtypes. And:

[E]ach of the many glomerular disease subtypes is unique. In certain subtypes, the immune system attacks the kidneys; in others, it damages the blood vessels.

As a result, the various subtypes are treated using different methods before the kidneys begin to fail. The treatments may include steroids or stronger immunosuppressant medications. The resulting side effects can range from severe infections to diabetes to cancer.

For their work, O'Shaughnessy and her colleagues examined data collected from 84,301 patients with end-stage kidney disease caused by one of six major subtypes of glomerular disease. The results showed that the type of glomerular disease significantly affected how long the patient lived after they developed kidney failure; mortality ranged from 4 percent per year for one type of patient to 16 percent per year for another.

"It’s important to know why one kidney patient does well and another does poorly," concluded O’Shaughnessy. "If physicians take into consideration what caused the kidneys to fail in the first place and what types of treatments patients received prior to kidney failure, it could possibly improve the patients’ quality of life or increase their life span."

Previously: Keeping kidney failure patients out of the hospitalStudy shows higher Medicaid coverage leads to lower kidney failure ratesStudy shows higher rates of untreated kidney failure among older adults and Geography may determine kidney failure treatment level
Photo by scribbletaylor

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