This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Glenn M. Chertow, MD; William F. Owen, MD; J. Michael Lazarus, MD
Brigham and Women's Hospital Boston, Mass

JAMA. 1994;272(4):274.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Medicare's end-stage renal disease (ESRD) program has been subject to renewed critical interest in recent years. The effectiveness of the program has been judged largely by patient survival and less so by objective measures of quality of life such as employment status; neither of these have reached physician or societal expectations. The article by Dr Ifudu and colleagues¹ describes "dismal" rehabilitation in geriatric inner-city hemodialysis patients. Despite the authors' claim to the contrary, we are concerned that this article may present a short-sighted interpretation of the data and provide ammunition for those who wish to institute age-based rationing of hemodialysis.¹

As determined by modified Karnofsky scores, the authors report a significant reduction in overall functional status compared with 2 years before the initiation of maintenance hemodialysis (mean, 5.3 years; up to 11 years previously). It is unclear how much of this decline in functional status . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?