Does Dialysis Work Better at Higher Altitude?

Many people in the United States today suffer from kidney failure and approximately 200,000 of them use dialysis treatment on an ongoing basis. New research is showing that patients on dialysis who live at higher altitudes survive severe kidney disease much better than the patients that live closer to sea level, thanks to the changes in the body at the greater elevations.

Patients usually require dialysis treatment when the waste products in their body become so high that they actually start to get sick from them. The levels of the waste products usually build up rather slowly. The doctors will measure several blood chemical levels to help them decide when dialysis becomes necessary. The two major blood chemical levels that are measured to see if dialysis is necessary are the creatinine level and the blood urea nitrogen level. As these two chemical levels rise they are indicators of the decreasing ability of the kidneys to cleanse the body of its waste products.

There also two main forms of dialysis that can be used: peritoneal dialysis and hemodialysis. The hemodialysis uses a special type of filter to remove the excess waste products and water from the body. The peritoneal dialysis uses a fluid that is placed in the stomach of the patient cavity through a special plastic tube to remove the excess waste products and fluid from the body.

The researchers from this new study on dialysis stated that compared to the patients that are living close to sea level, those at elevations of 4,000 to 6,000 feet have a 12 percent better rate of survival after five years, and those that are living above 6,000 feet have a 15 percent better rate. In fact, the rate of survival for the patients that have end-stage kidney disease who have dialysis rose steadily as the altitude of where they lived increased, the researchers wrote in the Journal of the American Medical Association.

Dialysis treatment does some of the things that the failing kidneys can no longer do. These things include removing salt, extra water, and waste from the body by maintain levels that are safe of certain chemicals in the blood and helping control the patient’s blood pressure.

Dr. Wolfgang Winkelmayer, of the Brigham and Women’s Hospital at the Harvard Medical School in Boston and also lead author of the study, stated, “The prognosis once you have end-stage renal disease and require dialysis is really grim. It compares to having certain types of cancer…. Once a person reaches end-stage renal disease, the only treatment options are either to undergo dialysis or kidney transplant.”

For this study, the researchers analyzed data on approximately 804,812 U.S. patients on dialysis, figuring their altitude by using their postal zip code.

A previously conducted study found that patient on dialysis that were living at higher altitudes responded better to treatment by using a protein called erythropoietin that controls the production of red blood cells. The researchers stated that hypoxia, which is a deficiency of oxygen in the blood that occurs at higher elevations, may take erythropoietin more effective. The researchers also added that there could also be other benefits of mild hypoxia for patients that are undergoing dialysis.

U.S. cities that are between elevations of 4,000 to 6,000 feet include Boulder and Denver, Colorado and Albuquerque, New Mexico, and those cities that are above 6,000 feed include Colorado Springs, Colorado and Santa Fe, New Mexico.

Here is an example of the survival advantages for the different altitudes:
•    Patients that are living at 250 to 1,999 feet is 3 percent.
•    Patients that are living at 2,000 to 3,999 feet is 7 percent.
•    Patients that are living at 4,000 to 5,999 feet is 12 percent.
•    Patients that are living above 6,000 feet is 15 percent.