By Bill Peckham
Attending a national kidney meeting, Renal Week for example, drives home that many people in the renal community believe society could be doing better for people on dialysis. How to accomplish improvement is in dispute but people from all sides of the industry agree that the current way dialysis is provided is not optimal.
One item often cited to improve is the "dialysis mortality rate". It is said that the dialysis mortality rate is lower abroad. As low as 9% in Japan. Indeed, I've written the phrase "dialysis mortality rate", unprompted, on this blog. However, I now realize that to refer to the "dialysis mortality rate" is to refer to a myth. The myth that dialysis is dangerous, is deadly. Indeed that there is a significant dialysis mortality rate. The entire verbal construct is wrong.
Dialysis is good. Dialysis is not dangerous. Too little dialysis is dangerous. It is as if standard medical practice was to give someone only half the insulin they need and then call the resulting deaths, deaths from insulin. We'd be reading about the high insulin mortality rate. No, no, no. The cause of death would be under-treated diabetes. This is the situation we face in the provision of dialysis. We have a high mortality rate from under-treated CKD5.
For a myriad of reasons a bare minimum dose of dialysis is all that is routinely available in the United States for people with CKD5. People with CKD5 face a high death rate because they do not receive a transplant or enough medicine, enough dialysis. Dialysis is medicine. Dialysis treats stage 5 CKD as surely as insulin treats diabetes.
The myth of the high dialysis mortality rate must be exposed as a misnomer, a fraud. Let us see dialysis instead for what it truly is: life saving medicine. The fight we all should engage is to ensure everyone has access to the proper dose of medicine. The proper dose of dialysis.