Dr Alan Kliger Outlines Major Safety Risks for Patients Receiving Dialysis

Some of the most common safety risks for patients receiving dialysis include medication safety, infections, and falls, according to Alan Kliger, MD, clinical professor of medicine at Yale University School of Medicine.

Transcript

What are the major safety risks of dialysis, and how common are they?

Patients on dialysis are complex; they have multisystem disease and therefore the possibility of problems, the possibility of errors, the possibility of safety issues is higher than for other patients. Patients on dialysis have particular areas of safety concern. First is medications; patients on dialysis often take more than 6 and sometimes more than 16 different medications, each with different time intervals, each with different indications, sometimes with interactions, and so medication safety, taking the right medicine at the right time in the right combinations, is a major safety issue for patients.

A second is infections, something that I’ve been involved with recently. Eleven percent of dialysis patients die as a direct result of infections, making it the second leading cause of death only after heart and vascular disease. And more hospital days are spent as a result of infection than cardiovascular disease. So infection and particularly preventable infections is a substantial source of safety problems for patients.

Other things include falls, which are common and often incapacitating when they result in fracture for patients on dialysis. And vascular access issues, issues around the fistula, bleeding catheter problems. So those are sort of the major risks of dialysis patients.