Despite 40 years of experience with dialysis, the death rate in American dialysis centers is higher than some countries in Europe and Asia and a new study suggests one possible explanation: the treatment seems to thicken the blood, which in turn puts stress on blood vessels and could increase the risks for a cardiovascular death. Two of the most common reasons that kidneys fail are hypertension and diabetes.
Steven Fishbane, MD, vice president of Network Dialysis Services for North Shore-LIH Health System and director of clinical research for the Department of Medicine at North Shore University Hospital and LIJ Medical Center, and his colleagues started looking at a variety of factors to explain the high death rate. With a pilot grant and a new device that allows them to measure blood viscosity, the researchers scanned blood vessels before, during and after kidney dialysis. They say they were surprised to find that there was a surge in thickness of the blood – in both large and small vessels – that occurs during dialysis. The thickness was observed more often in patients who retained a lot of fluid between treatments.
It is not clear what causes this thickening. Dr. Fishbane has his suspicions. The average lifespan for a dialysis patient in the US is significantly shorter in European and Asian countries. One possible explanation is the use of shorter dialysis sessions. Extending the treatment over a longer period of time could be less stressful to the blood vessels, researchers say. Dr. Fishbane and his colleagues are now collaborating with a team in France to test blood thickness in European patients.
Dr. Fishbane presented his findings on Friday at the American Society of Nephrology annual meeting in Philadelphia.
“We may be delivering dialysis the wrong way,” said Dr. Fishbane. There are about 300,000 people in the US on dialysis and the numbers are expected to climb to 500.000 in the next 20 years as rates of diabetes and obesity continue to climb.
Media Contact: Jamie Talan