Health: Dialysis Will Not Disappear

The Story:

As long as thirty years ago, there was a strong feeling in some circles that dialysis, the common method of treating kidney failure, had little or no future. Unfortunately, subsequent medical progress has not made dialysis obsolete. Nor, according to at least one expert, is that a likely prospect in the next few years.

Significance:

The first dialysis machine was created by a Dutch physician, Willem Kolff, in 1943. It spread to the United States early (Kolff himself came to the US after the war.)

There have been many advances since in the mobility and convenience of the treatment. But it is a life-long treatment that imposes considerable costs, on the patient, on private insurers, Medicare/Medicaid, or others, creating continuing pressure for finding another way of addressing the kidney conditions that call for it. Since circa 1990, there have been regular proclamations that something new was near at hand: implantable or wearable kidneys, for example.

In Pill Form:

Kamyar Kalantar-Zadeh, chief of the division of nephrology at the UC Irvine School of Medicine, wrote recently in a medical journal that the use of dialysis has expanded exponentially over the last three decades. There is still, and for a long time yet there will be, a lot of people who need it.

Furthermore (Kalantar-Zadeh warns) there may be pressure upon elderly patients with kidney favor to choose end-of-life palliative care rather than dialysis. But, he says, as a nephrologist, he assures his elderly patients that the necessary therapy will be available to them. “I tell all my patients that, as long as I am around, you will be too, if you choose to be.”

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