Introduction and Missed Dialysis Sessions

We want to educate all of our dialysis patients about important items that help determine how healthy they will be.  I particularly want to stress things that patients can do that either can make the patient healthier or less healthy.

This includes actions that:  1) increase or decrease the chance that you will die over the next year, 2) increase or decrease the number of days that you will be hospitalized this year and 3) increase or decrease how healthy you feel.

While I do not want to be overly blunt, I also want to get across that point that there are lots of things you can do with the help of your doctor and dialysis team to be as healthy as possible for as long as possible.

Each letter I send you will usually cover one item.  I encourage you to read these and to seriously consider how these items apply to you and in what ways you can improve your health by following my advice.  I also encourage you to share these with your loved ones at home.

Missed Dialysis Sessions:

The key to a healthy life on dialysis is coming for all of your dialysis treatments.  The chance that you will die over the next year is more than 10% higher in patients who miss 1 treatment each month. Patients who miss 2 treatments each month have as much as a 25% higher chance of dying over the next year.  Missing dialysis also makes hospitalizations much more likely.  Unfortunately, we often have patients who miss their dialysis and are admitted to the hospital before their next treatment.  It is not uncommon for patients who miss dialysis to be admitted to the intensive care unit on a breathing machine.   Some of our patients who miss dialysis even die at home. Last year in our unit, a healthy man in his 30’s on a dialysis Tuesday, Thursday, Saturday schedule missed Saturday dialysis and died in his sleep on Tuesday morning.

We have known for many years that patients who get dialysis in the United States die sooner than patients who get dialysis in Europe or Japan.  One of the reasons seems to be the striking difference in missed dialysis treatments.  Americans on dialysis are more than 10 times more likely to miss dialysis than patients in Europe or Japan.  In Europe and Japan, missing dialysis virtually never happens.

Your Doctors are available to answer any questions you may have about this.