#3430 MORTALITY AND RISK FACTORS IN VERY ELDERLY PATIENTS WHO START HAEMODIALYSIS: KOREAN RENAL DATA SYSTEM (KORDS), 2016-2020

Abstract

Abstract Background and Aims The number of elderly patients with end-stage renal disease (ESRD) is increasing worldwide. However, decision-making about elderly patients with ESRD remains complex because of the lack of studies, especially in very elderly patients (≥75 years). We examined the characteristics of very elderly patients starting haemodialysis (HD) and the associated mortality and prognostic factors. Method Data were analysed retrospectively using a nationwide cohort registry, the Korean Renal Data System. Patients who started HD between January 2016 and December 2020 were included and divided into three groups according to age at HD initiation (<65, 65–74, and ≥75 years). The primary outcome was all-cause mortality during the study period. Risk factors for mortality were analysed using Cox proportional hazard models. Results In total, 22,024 incident patients were included with 10,006, 5,668, and 6,350 in each group (<65, 65–74, and ≥75 years, respectively). Among the very elderly group, women had a higher cumulative survival rate than men (91.2% vs. 90.3% at 1 year and 56.4% vs. 51.9% at 3 years, respectively) (Figure 1a). The survival rate was lower in patients with vascular access via a catheter than in those with an arteriovenous fistula or graft (72.0% vs. 95.1% at 1 year and 23.8% vs. 60.7% at 3 years, respectively) (Figure 1b). Very elderly patients with more comorbid diseases had a significantly lower survival rate that those with fewer comorbidities (log-rank: p < 0.001) (Figure 2). Conclusion Preparation of an arteriovenous fistula or graft when starting HD should be considered in very elderly patients with fewer comorbid diseases.