Aggressive Early Kidney Dialysis Kills Patients: Yet another demonstration of the fraud of evidence-based medicine.

Early dialysis of kidney disease patients is killing them at 3 times the rate of those started later, according to a report to be announced this week in theJournal of the American Medical Association’s(JAMA) Archives of Internal Medicine. As ever, the claim to evidence-based medicine is turned on its ears. There was never any study documenting benefit with early dialysis. Doctors simply presumed it would help, and with that presumption they have turned thousands of kidney patients into unwitting guinea pigs.

According to the article:

So the theory was that malnutrition should be avoided by starting dialysis earlier, at least in patients who show signs of malnutrition, including low albumin level or low protein intake. Another line of reasoning held that levels of kidney function at which dialysis was being started fell well below levels that would beconsidered adequate for continuous dialysis therapy and that it would be logical to start dialysis around the level of kidney function equivalent to adequate peritoneal (continuous) dialysis.

In other words, doctors decided to do a mass study of the effects of aggressive early dialysis. Do you suppose the patients were advised that they were test subjects?

Kirsten L. Johansen wrote a JAMA editorial in advance of the study’s publication, scheduled for the March issue. She stated that, not only was the death rate significantly higher, but early dialysis appears to do nothing for quality of life. So patients’ lives were shortened for no benefit. She states that current practice is not supported and:

The bar for these symptoms has been dramatically lowered in recent years with no data to support a benefit to patients…From a research perspective, we need to focus our efforts on examining the quality-of-life implications of timing of dialysis initiation.

The Study

The authors of the study examined data for 81,176 patients, aged 20-64, who were started on dialysis between 1996 and 2006. If any other illness existed, aside from high blood pressure, patients were not included in the study.

The overall death rates were 9.4% during the first year of dialysis, and 7.1% the second year.

Patients who were started early died at a rate of 20.1% during the first year, as opposed to 6.8% of those started at what had previously been considered the appropriate time. Early dialysis results in nearly three times the number of deaths in the first year!

The authors concluded:

Hemodialysis is an invasive, lifelong, potentially dangerous intervention. These results and those of other recent studies have failed to find benefit in early dialysis and suggest the potential of harm.

Complications of Dialysis

As Kirsten Johansen noted, kidney dialysis is invasive. It’s a miserable procedure to undergo, and patients who are started on it can expect to go through it frequently for the rest of their lives. At a minimum, patients become absolutely tied to the procedure and the medical system. Their lives are circumscribed by the need to be available and by its effects.

Patients are usually subjected to drugs to control symptoms caused by dialysis, such as drop in blood pressure, increased risk of infection, cramps, nausea, headache, electrolyte imbalance, and anemia. There is also the chance of being infected with hepatitis through improper care of equipment. The procedure itself sometimes results in one of two severe conditions: amyloidosis (autoimmune disorder causing deposits of proteins in tissues)or acquired cystic kidney disease.

Evidence-Based Medicine?

As documented in Antibiotics Linked to Cancer: Implications for Evidence-Based Medicine, the term evidence-based medicine has become little more than a marketing tool, used to pressure and coerce patients into submitting to invasive, agressive, and life-threatening procedures. The term is tossed around to imply that only modern medicine has truth, and that alternatives fall short.

The reality, though, seems to be entirely different. How many kidney patients have been coerced into early dialysis with statements that it’s obvious or proven to be beneficial? How many of them suffered a reduced quality of life and died prematurely as a result?

How much money was made by doctors, hospitals, medical device manufacturers, and Big Pharma as a result of early application of dialysis in kidney patients? We keep hearing the term, evidence-based medicine, trotted out with the implication that all of modern medicine’s procedures and drugs have first been vetted by going through a process designed to determine what’s best for the patient. Obviously, that is far from the truth.

Kidney disease is, of course, a serious issue. Dialysis may be the only thing that can help. It is, though, fraught with risks. It’s incomprehensible that anyone would allow himself to be subjected to it without first looking into alternative treatments. As should now be obvious, an assumption that your doctor has your best interests at heart and is providing you with full information could easily lead to a premature death preceded by severe deterioration in quality of life. The reality is that most medical doctors are tied into a system that narrows their vision of potential ways to treat disease—and even ties their hands, should they dare to look outside the mainstream-accepted paradigm.

In the end, it’s necessary to realize that no one else lives inside your skin, and no one else will live with the results of your medical treatment. You have a choice of blindly following what your doctor says or looking around to see what else might be available. Any claims that you’re putting your life at risk by doing so are shown to be a farce in light of the news that early kidney dialysis results in tripling the chance of dying within the first year of treatment.

Read original (and references) here.