MON-160 VIABILITY OF PALLIATIVE CARE AS A TREATMENT OPTION FOR ELDERLY PATIENTS WITH END-STAGE RENAL DISEASE IN TWO TERTIARY HOSPITALS IN SOUTHEAST NIGERIA; A PRELIMINARY REPORT

Abstract

The number of elderly patients developing end-stage renal disease (ESRD) is on the increase in Nigeria. With multiple co-morbid conditions, evidence is needed to inform decision making for or against dialysis among these patients. A cross-sectional analysis of patients from 60 years and above with ESRD who were treated with either haemodialysis or palliative care over a period of two years in two tertiary hospitals in SouthEast Nigeria. The symptom burden, quality of life and functional status were assessed by standard validated methods. Survival was defined as time from diagnosis of ESRD to either death or been censored. Kaplan-Meier survival analysis and Log rank test was used to estimate and compare survival. Cox proportional hazard regression models were used to investigate the impact of independent variables on survival. Haemodialysis was offered to 114 (75%) while 38 (25%) choose palliative (non-aggressive) renal care for various reasons. Patients who opted for palliative care had a significantly higher mean symptom burden score and lower quality of life scores than their counterparts on dialysis treatment (p=0.760). There was no significant difference in mean functional status scores between the two groups (p=0.837). The mean survival time for those on dialysis treatment (7.1 months) was slightly higher than mean survival time for those on palliative care (5.8 months) but there is no significant evidence of difference in survival times for both groups (Log rank = 1.2, p=0.27). Palliative care may be a viable option for management of ESRD as it has comparable survival advantage with haemodialysis; howbeit with a higher symptom burden and lower quality of life.