Chronic dialysis in elderly and senile patients: survival and factors affecting outcome. Single-center experience
- Authors: Kurilovich K.A.1,2, Komissarov K.S.3, Krasko O.V.4
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Affiliations:
- 1st City Clinical Hospital
- Belarusian Medical Academy of Postgraduate Education
- Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology
- Joint Institute for Informatics Problems of the National Academy of Sciences of Belarus
- Issue: Vol 15, No 1 (2023)
- Pages: 58-64
- Section: Original Articles
- URL: https://bakhtiniada.ru/2075-3594/article/view/275299
- DOI: https://doi.org/10.18565/nephrology.2023.1.58-64
- ID: 275299
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Abstract
Objective. Evaluation of the survival and mortality predictors in patients ≥60 years of age on chronic dialysis (CD).
Material and methods. Data analysis of 199 patients ≥60 years of age on CD: 183 (92%) on program hemodialysis (PHD),
16 (8%) on continuous ambulatory peritoneal dialysis (CAPD).
Results. Median survival was 279 days for PHD, and 650 for CAPD; 1-year survival for PHD was 46.5±3.8%, for CAPD – 81.2±9.8%, 2-year survival for PHD was 33, 3±3.9%, for CAPD – 37.2±13%. Univariate analysis of mortality predictors: PHD vs CAPD method (hazard ratio – RR=1.9, 95% confidence interval – CI 1.04-3.6), age (RR=1.7, 95% CI 1.1-2.6), the presence of type 2 diabetes mellitus – DM2 (RR=1.5, 95% CI 1.1–2.2), the presence of overhydration (RR =1.7, 95% CI 1.2–2.4), pre-dialysis creatinine (Cr) (RR=1.1, 95% CI 1.03–1.2) and urea levels (RR=1.04, 95% CI 1.02–1.05). Multivariate analysis of mortality predictors: age, at the first year of treatment: Cr>1000 µmol/L, urea>45 mmol/L, start of renal replacement therapy (RRT) by PHD.
Conclusion. The peak of mortality in elderly patients occurs in the first year of PHD. CAPD can be considered as 1st line RRT in patients ≥60 years of age. To improve the first year survival of patients on RRT, further study of mortality predictors is required.
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##article.viewOnOriginalSite##About the authors
Kristina A. Kurilovich
1st City Clinical Hospital; Belarusian Medical Academy of Postgraduate Education
Author for correspondence.
Email: cn@bionika-media.ru
ORCID iD: 0000-0002-9112-4863
Belarus, Minsk; Minsk
Kirill S. Komissarov
Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology
Email: cn@bionika-media.ru
ORCID iD: 0000-0002-2648-0642
Belarus, Minsk
Olga V. Krasko
Joint Institute for Informatics Problems of the National Academy of Sciences of Belarus
Email: cn@bionika-media.ru
ORCID iD: 0000-0002-4150-282X
Belarus, Minsk
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