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  1. #1
    Join Date
    03-10-06
    Posts
    279

    Question Longevity on daily nocturnal

    Hi Dr. Agar,

    How long can people survive on daily nocturnal? While there have been outliers who've been on dialysis (even in-centre) for decades, I was wondering what the (statistical) mode of the survival number of years (maybe a range) of daily nocturnal patients would be, in your guesstimate?

    I'm asking because the last couple of years, I have been on a slippery slope with regard to my health. It started off with neurological issues (convulsions, severe numbness), then it was the heart, then osteoarthritis. Even things like coughs and stomach bugs are becoming difficult to treat - take more time, more drugs.

    I've been on dialysis for almost 20 years now - 2 on in-centre HD, 7 on PD and almost 11 on DNHHD.

    It's not that I am depressed or anything. But I was just wondering what the statistics said.

    - Kamal

  2. #2
    Join Date
    11-17-09
    Location
    Geelong, Victoria, Australia
    Posts
    470

    Default Re: Longevity on daily nocturnal

    Dear Kamal

    I wish I could help you here but it's very complex. First, it IS true, that in most programs, home and especially home nocturnal patients tend to be younger, and often fitter. This is just a fact ... and it often one of the major selection bias issues thrown back at home programs to point out their better survival data. And, selection bias IS an issue. So ... home and home nocturnal patients - as a group - start out younger.

    Next, more home and home nocturnal patients transition to transplantation ... so, for years of survival of ESRD, the data is confounded by transplantation outcomes.

    That said, the data certainly suggests much greater longevity at home, and especially in the home nocturnal high intensity dialysis group, and, in several Canadian and US reports - albeit troubled by many of the same undeniable biases - the outcomes (the survival) in home nocturnal dialysis patients parallels the survival of deceased donor (but are not as good as living donor) transplant recipients.

    But for any one individual patient? ... sadly, it is impossible to say.

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