Abstract

An increasing number of elderly people in renal support is expected in the coming years. The objective of this study was to report the clinical and socio-demographic data of end-stage renal disease (ESRD) adult patients undergoing regular dialysis treatment comparing elderly (≥65 years old) and non-elderly subjects using data from the Brazilian Dialysis Registry database. The regional distribution of the sample was Southeast (48.8%), South (33.7), Northeast (13.1%), Midwest (5.1%), and North (0.1%). A total of 18,030 patients were included in the analysis with elderly patients accounting for 29.5% of the sample. The elderly patients were predominantly male, white, retired, and literate. Elderly ESRD patients had a slightly higher frequency of undernourishment and a lower frequency of obesity than the non-elderly adults. A higher frequency of elderly patients were from the South and Southeast regions. The dialysis treatment of patients from both groups was predominantly funded by the public system, but the percent of non-public funding was higher for the elderly group. The most used initial access in the elderly was the central venous catheter and hemodialysis was the main modality at the beginning of treatment (93.2%), as well as during maintenance therapy (91.8%). Advanced age was associated with greater use of central venous catheter in the first dialysis session. The survival of the elderly on dialysis was lower than that of the non-elderly early in the course of dialysis and this difference increased over time. This is yet the largest national epidemiological study of elderly people on chronic dialysis.

Highlights

  • In most countries, the prevalence of end-stage renal disease (ESRD) patients has been increasing in recent years [1,2,3]

  • The aging of the population coupled with improved management of comorbidities, technological advances in renal replacement therapy (RRT), more liberal admittance to dialysis, and better acceptance of dialysis support have resulted in the expansion of the geriatric population on dialysis

  • The prognosis and decision-making process regarding the start of chronic dialysis in this age group remains controversial [6]

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Summary

Introduction

The prevalence of end-stage renal disease (ESRD) patients has been increasing in recent years [1,2,3]. The aging of the population coupled with improved management of comorbidities, technological advances in renal replacement therapy (RRT), more liberal admittance to dialysis, and better acceptance of dialysis support have resulted in the expansion of the geriatric population on dialysis. This increase has been seen in the age group above 75 years, who may carry multiple comorbidities and are less independent and more fragile [5,6]. The prognosis and decision-making process regarding the start of chronic dialysis in this age group remains controversial [6]

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