Nephrology Dialysis Transplantation, Vol 13, Issue 5 1226-1233, Copyright © 1998 by Oxford University Press
S Harris and E Brown
Background: The purpose of this survey was to describe
the natural history of complications in 52 long-surviving haemodialysis
patients to obtain a clearer picture of the impact these patients have on
the dialysis population. This is important as they are often no longer
suitable for transplantation and therefore are destined to remain on
dialysis for the rest of their lives. Methods: The
patients who survived for more than 10 years on haemodialysis alone were
studied. Information was obtained from patients' records and from the renal
unit computer. Results: Mean age at start of dialysis
was 43 years and mean duration of HD 14.5 years. Renal failure was most
commonly due to polycystic kidney disease or glomerulonephritis. Sixty-two
percent of patients developed cardiovascular disease, 78% complained of
joint pains, 72% had a parathyroidectomy, and 50% developed carpal-tunnel
syndrome. Two hundred and forty-five episodes of infection were recorded,
41% related to vascular access acquired in hospital or on
immunosuppression. Only three infections occurred which could be described
as opportunistic. Twelve patients were hepatitis C positive. In the 37
patients who have died, cardiovascular disease was the most common cause of
death. Compared to other patients who started on dialysis before 1986 but
who had a successful transplant the survival of patients on haemodialysis
is much worse. Conclusion: Long-term survival on renal
replacement therapy is dependent on successful transplantation.
Complications, morbidity, and mortality are high after 10 years of
dialysis. Key words: cardiovascular disease;
complications; dialysis amyloid; long-term haemodialysis; musculoskeletal
disease; survival
ORIGINAL ARTICLES
Patients surviving more than 10 years on haemodialysis. The natural history of the complications of treatment
Department of Renal Medicine, Charing Cross Hospital, Fulham Palace Road, London W7 8RF, UK; Corresponding author
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