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Higher Physician Caseload LInked With Earlier Deaths Among Kidney Patients

Update Date: Aug 08, 2013 05:09 PM EDT

Dialysis patients may live longer if their kidney specialist takes on fewer patients, according to a new study.

New research reveals that nephrologists whose patients had the best survival over six years had a significantly lower patient caseload than those whose patients had the worst survival.

The finding revealed that patients risk of dying within six years raised by 2 percent for every 50 patients cared for by their nephrologists.

Researchers said that the latest study is the first of its kind to examine the association between nephrologist caseload and mortality risk in a large urban US setting.

Lead researcher Kamyar Kalantar-Zadeh, MD, MPH, PhD, of the University of California Irvine Medical Center, and his colleagues, looked at whether hemodialysis patients cared for by nephrologists with a higher patient caseload had a greater risk of dying prematurely than those receiving care from nephrologists with a lower caseload.  The study involved a total of 41 nephrologists with a caseload of 50 to 200 dialysis patients from an urban California region were retrospectively ranked according to their dialysis patients' mortality rate between 2001 and 2007.

"Our data suggest that patients receiving care from nephrologists with lower caseloads may have greater survival," Kalantar-Zadeh said in a news release. "Such data may help direct health policies and guidelines more effectively."

Researchers said the next step is to confirm the latest findings and to explore mechanisms by which caseload influences patients' outcomes.

The findings are published in the Journal Of The American Society Of Nephrology

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