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Fewer hospitalizations for advanced kidney failure patients who choose conservative management

December 06, 2022
Connie M. Rhee, MD, photographed in white lab coat sitting in front of blue background.

Connie M. Rhee, MD

IN THE NEWS: Patients who choose conservative management for advanced kidney disease have lower hospitalization rates than patients who opt for dialysis, according to a study presented at the American Society for Nephrology's annual conference by UCI Health nephrologist Dr. Connie M. Rhee.

"Given evidence that dialysis results in greater healthcare utilization and morbidity among certain subgroups, there is rising interest in conservative management as an alternative patient-centered treatment strategy,” Rhee, the study's lead author, told Healio.com.

Conservative management (CM) for kidney failure, also known as chronic kidney disease (CKD), means that a patient's care is focused on quality of life and symptom control and does not involve dialysis or a kidney transplant, according to the National Institute for Diabetes and Digestive and Kidney Diseases. Patients have the right to decide how their kidney failure is treated.

For the study, published earlier this year in the journal of the International Society of Nephrology, researchers reviewed data on hospitalization rates for 309,188 patients with advanced CKD who were treated either with CM or dialysis between January 2007 and June 2020.

Results showed that 55% of advanced CKD patients in the study had at least one hospitalization within two years. However, patients who started dialysis rather than choosing CM had the highest rates of hospitalizations across all age groups.

The most common causes of hospitalization in both the CM and dialysis groups were congestive heart failure, respiratory illness or hypertension, according to Rhee, an associate professor and vice chair of research for the UCI School of Medicine's Department of Medicine.

“We observed differential relationships between CM vs. dialysis on hospitalization rates across race, ethnicity and age,” she and her colleagues concluded. “Further research is needed to determine which patients are optimal candidates for CM vs. dialysis using a personalized approach.”

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