By Bill Peckham
What is the expected lifespan of someone who needs dialysis? This is a recurring topic on the discussion boards, listservs and blogs. I also see it is a frequent Google search. DSEN is one of the top Google results for a variety of ways to ask the question: How long will I live?
Will I live? is often the first question a person has when hearing that dialysis is in their future.
One Two things to know - you can live a long time on dialysis; do not max out your credit cards.
Remember when looking at statistics that averages are made of extremes. If five patients live two years and one patient lives twenty years, the average life span would be five years. This is called a bimodal distribution and really the average has little meaning to either group.
Keep in mind when you are looking at these numbers, that they are a blend of at least two averages. The average life span of dialyzors who do follow their exercise, diet and treatment prescriptions, and the average life span of dialyzors who do not follow their exercise, diet and treatment prescriptions. (Exercise: movement to the extent possible; Diet: whatever you have to do to have good lab reports and avoid excessive fluid removal each treatment; Treatment: showing up and staying on for the duration dialysis, and taking prescribed medications properly.)
The United States Renal Data System tracks dialysis mortality rates and issues the USRDS Annual Report there you'll find Section 6 Morbidity & Mortality (PDF link) this is where you'll find the relevant averages for your age and gender.
The report is updated every year; for 2007 the relevant table is: Table 6d Expected remaining lifetimes (years) of the U.S. population & of dialysis & transplant patients, by age, gender, & race. As you look for the relevant age group remember, averages are made of extremes and that this is all based on the assumption that the treatment is incenter, 3 days a week. There are much better dialysis alternatives.
More frequent and/or longer dialysis has a significant positive impact on mortality. Dialyzing every night, over night, as I do, improves your expected mortality to the point that it rivals having a kidney transplant from a deceased donor. Keep in mind too that these numbers are based on historic results; because of constant improvements in drugs and treatment, no one knows how long someone starting dialysis today can expect to live. No one knows how long you, a unique individual, will live.
If you've just heard about dialysis go ahead and look at the statistics, but know there is a lot you can do to stay right of average. For the rest of the story checkout these nonprofit, independent, educational websites: Kidney School, Nocturnal Home Haemodialysis and Home Dialysis Central. You'll learn that with the proper dose, dialysis works well and you can live a life very similar to the one you were meant to live but for severe chronic kidney disease. This 12 part series of educational videos from IKAN Kidney does an excellant job addressing the most common questions people have when they learn they have kidney disease (follow link and press "Play All" at the top of the page to watch them in order, ~43 minutes).