HbA1c is Independent Prognostic Factor for Elderly ESRD Patients

Abstract

The eldery constituted the fast growing segment of the end-stage renal disease (ESRD) population. However, the information about the elderly patients on hemodilaysis therapy is limited. We investigated outcomes and the prognostic factors for elderly patients who initiated hemodialysis. We reviewed medical recodes and conducted survival analysis in elderly patients over than 75 years when they had started hemodialysis in single center between 1988 and 2010. We analyzed the survival time of elderly hemodialysis patients with Korean national health insurance data system. Sixty hundred and sixty eight patients initated hemodialysis from 1988 and sixty five patients among them were over than 75 years. Their median survival from initiation of hemodialysis was 29.02 (13.31-49.51) months. The survival in patients whose HbA1c level was higher than 7.0% was lower than in their counterpart (32.85 Vs 13.31 months; P=0.0014).The patients with AVBG and AVF showed much better survival compared to catheter (36.75, 32.46 Vs 3.26 months; P=0.0016). The patients over than 80 years were 43% and their survival was much lower than the patients younger than 80 years (16.00 Vs 36.75 months ; P=0.0107). Cox regression analysis showed the HbA1C >7.0% is independent prognostic factor. (HR=4.66 (1.79-12.16), p=0.002). In conclusion, Diabeus mellitus per se was not a risk factor for mortality in this group. However untrolled diabetes mellitus is independent prognostic factor for elderly ESRD patients.