The clinical status and survival in elderly dialysis: example of the oldest region of France

BMC Nephrology

Jean Claude Aldigier⁴  Cécile Couchoud³  Michel Rincé⁴  Jean Philippe Rerolle⁴  Jean Michel Poux²  Pierre Peyronnet¹  Maria Manescu²  Christian Lagarde¹  Céline Lacour⁴  Philippe Honoré⁵  Marie Essig⁴  Zara Dickson¹  Monica Ciobotaru⁵  Jean Pierre Charmes¹  Béatrice Champtiaux¹  Rémy Boudet⁵  Frédérique Bocquentin⁴  Vincent Allot⁴  Julien Allard⁴  Carine Hottelart¹  Florence Glaudet⁴ 

[1] ALURAD (Limousine Association for the use of the artificial kidney at home, Limoges, France;ALURAD (Limousine Association for the use of the artificial kidney at home, Brive, France;REIN registry, Biomedecine Agency, La Pleine-Saint Denis, France;Nephrology Unit, Limoges University Hospital, Limoges, France;Nephrology Unit, Brive Hospital, Brive, France

关键词: Survival;    Outcome;    End stage renal disease;    Elderly;    Co-morbidity;   

Others  :  1082908
DOI  :  10.1186/1471-2369-14-131

 received in 2012-11-27, accepted in 2013-06-05,  发布年份 2013

【 摘 要 】

Background

The number of elderly (≥75 years) patients with end-stage renal disease (ESRD) has increased markedly, including in the Limousin region, which has the oldest population in France. We retrospectively compared outcomes in elderly and non-elderly ESRD patients who started dialysis during two time periods.

Methods

Baseline clinical characteristics, care, and survival rates were assessed in 557 ESRD patients aged ≥75 and <75 years who started dialysis in 2002–2004 and 2005–2007. Survival curves and Cox proportional hazards model were used to assess survival and factors associated with survival.

Results

Of the 557 patients, 343 and 214 were <75 years and ≥75 years, respectively. Dialysis was started in 2002–2004 and 2005–2007 by 197 and 146 patients <75 years, respectively, and by 96 and 118 patients ≥75 years, respectively. Median age (73.4 years [interquartile range [IQR] 61.7-79.5 years] vs 69.5 years [IQR 57.4-77.4 years] p = 0.001) and the proportion aged ≥75 years (44.7% vs 32.8%, p = 0.004) were significantly higher in 2005–2007 than in 2002–2004. Improved initial status during 2005–2007 was observed only in patients ≥75 years, with a decrease in some co-morbidities, improved walking and better preparation for dialysis. Mortality rates were significantly lower in 2005–2007 than in 2002–2004 (hazard ratio 0.81, 95% confidence interval 0.69-0.95; p = 0.008), with the difference due to factors associated with clinical status and care.

Conclusions

Improved initial clinical status and better preparation for dialysis, accompanied by increased survival, were observed for patients ≥75 years who started dialysis more recently, perhaps because of early referral to a nephrologist.

【 授权许可】

   
2013 Glaudet et al.; licensee BioMed Central Ltd.

【 图 表 】

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