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To live longer, kidney patients should move to Denver

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Or sleep in a high-altitude tent like those used by bike racers and other athletes.

That, at least, is the inference from a report today showing that dialysis patients who live at high elevations have a 12% to 15% lower risk of death. The study was prompted by previous observations that dialysis patients who live at high altitudes achieve higher levels of oxygen-carrying hemoglobin in their blood with lower doses of erythropoietin, which stimulates red cell production. This increased concentration of red blood cells is why many athletes train at high altitudes, hoping that the extra red cells will increase their endurance once they return to sea level.

Dr. Wolfgang C. Winkelmayer and his colleagues at Brigham and Women’s Hospital in Boston analyzed health records for 804,812 patients with end-stage kidney disease who began dialysis between 1995 and 2004, dividing them into groups based on the average altitude of their ZIP codes. The vast majority lived at altitudes below 250 feet (40.5%) or between 250 and 1,999 feet (54.4%). Only 1.9% lived at altitudes between 4,000 and 5,999 feet, and 0.4% lived higher than 6,000 feet.

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They reported in the Journal of the American Medical Assn. that, during the period of the study and controlling for other factors, those living at 250 to 1,999 feet were 3% less likely to die than those living at the lowest altitudes; those living at 2,000 to 3,999 were 7% less likely to die; those living at 4,000 to 5,999 were 12% less likely to die; and those living above 6,000 feet were 15% less likely to die.

Overall survival was low in all cases, however. Five-year survival was 34.8% for patients living near sea level and 42.7% for those living at an altitude higher than 6,000 feet, a median survival difference of 11 months.

Of course, most dialysis patients can’t pack up and move to Big Bear or Denver or some other high-altitude location. But several manufacturers now make plastic bubbles for sleeping in which the oxygen levels are depleted to increase production of red blood cells. For someone committed to prolonging their life, that might provide a relatively simple answer.

-- Thomas H. Maugh II

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