Abstract
Background. To assess factors affecting survival in an octogenarian cohort commencing haemodialysis (HD) and describe outcomes associated with prolonged survival. Materials and Methods. We retrospectively analysed 11 years of data (1 January 2000–31 December 2010) from patients aged ≥ 80 years starting HD at a teaching hospital in the United Kingdom. Data was collected on patient demographics, aetiology of renal failure, indication and duration of HD, access type at first dialysis, Charlson comorbidity index score, and cause of death. Results. Data from 139 eligible patients was included for analysis (85 male, 54 female (1.54 : 1)). The mean age was 83.6±2.8 years and 90% of this cohort were Caucasian. Thirty percent (42/139) of the cohort died within 90 days of starting dialysis. For those who survived >90 days the mean (median) duration of HD was 871.8 (805) days. Long-term survival was more common in females and those who first dialysed through an AVF. Conclusions. There is a significant early mortality risk in octogenarians commencing HD. For individuals who survive beyond the initial 90 days, the majority have a good long-term survival and our results are better than previously published UK data. Long-term survival was more common in female patients and those starting HD using an AVF.
Highlights
Renal replacement therapy (RRT) was only considered a feasible treatment option in younger patients with little comorbidity [1, 2]
The world’s population is ageing and the growing prevalence of Chronic kidney disease (CKD), especially in the older adults, presents a major challenge to the health services. This is partly due to the paradigm shift which has occurred in nephrology over the last 30 years
Medical advances have meant that renal replacement therapy (RRT) is considered a real treatment option for an increasingly complex group of older patients
Summary
Renal replacement therapy (RRT) was only considered a feasible treatment option in younger patients with little comorbidity [1, 2]. Today HD is considered a viable treatment option for all ages including the very elderly as a result of positive advances in medicine [2]. In the UK, patients aged over 65 represent the fastest growing group of the dialysis population with their numbers increasing by a third between 2005 and 2008 [3]. Thirty percent (42/139) of the cohort died within 90 days of starting dialysis. For those who survived >90 days the mean (median) duration of HD was 871.8 (805) days. For individuals who survive beyond the initial 90 days, the majority have a good long-term survival and our results are better than previously published UK data. Long-term survival was more common in female patients and those starting HD using an AVF
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