Analysis incident dialysis situation effect on the prognosis of elderly patients undergoing hemodialysis

Abstract

Objective To investigate the clinical characteristics and laboratory examinations in incident dialysis effect on the prognosis of elderly patients undergoing hemodialysis. Methods Ninety-three patients aged 65 years or older initiating hemodialysis were enrolled from Hemadialysis Center of Beijing Hospital from January 1st, 2007 to June 30th, 2016.The duration time of HD of all patients was more than three months.Patients were divided into death group and non-death group.The clinical characteristics and laboratory examinations were compared between the two groups.Cox proportional hazards regression was used for the multivariate analysis to determine independent prognosis factors. Results The average year of patients was 74.2±6.5 years old with 43 months of median time of follow-up.The first two causes of death were infection(n=25, 49.0%) and cardiovascular and cerebrovascular diseases(n=16, 31.4%). Cox single factor regression analysis showed that the older ages, diabetic nephropathy being the cause of end-stage renal disease(ESRD), complicating with diabetes mellitus or congestive heart failure, the higher Charlson cardiovascular diseases score, ALB being under 35 g/L were correlated with poor outcome respectively(P<0.05). Cox multivariate regression analysis indicated that older ages(HR=1.056, P=0.021), diabetic nephropathy being the cause of ESRD(HR=2.661, P=0.001), the higher Charlson cardiovascular diseases score(HR=1.675, P=0.010), central venous catheters being vascular access(HR=1.167, P=0.048) on incident dialysis were the main risk factors for mortality in elderly patients. Conclusion The older ages, diabetic nephropathy being the cause of ESRD, the higher Charlson cardiovascular diseases score, central venous catheters being vascular access on incident dialysis are independent risk factors influencing survival of elderly patients. Key words: Elderly; Hemodialysis; Prognosis; First time dialysis