A recent paper in Nature Reviews, a peer reviewed science publication [ck], looks at the issue of the economics of dialysis, a standard treatment for people with failed or impaired kidney function. The scholars were concerned with what patients with kidney failure want from treatment. Some may find the conclusion surprising.
A functioning pair of kidneys maintains the body’s internal equilibrium of water and minerals. The minerals involved include sodium, potassium, chloride, calcium, and others. The kidneys are also involved in the excretion of acidic by-products of metabolism. A dialysis machine substitutes for kidneys in these functions, using diffusion (waste remolval) as well as ultrafiltration (water removal).
The authors of the new study find that the “overwhelming message” that researchers and specialists in the function and malfunction of kidneys (nephrologists) are receiving from patients is that “whole patients value longevity, reducing symptom burden and achieving maximal functional and social rehabilitation are prioritized more highly.”
In Pill Form:
The point made by these nephrologists and their patients can be generalized. In many areas in medicine, there has been a shift over time from the quantitative measure of “how many years/months” a patient has, to the qualitative issues of what they will be able to do with their time, in a life within a social context and how comfortably they will be able to lead it.