DIALYSIS IN NEW OLD PATIENTS

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E-Poster

https://storage.unitedwebnetwork.com/files/1099/df1c11332b067c03f062495a1d5a340d.pdf

Abstract Title

First Name *

Victor

Last Name *

Frajewicki

Co-author 1

Tatiana Tanasiyuchuk tatianata1@clalit.org.il Carmel Medical Center Department of Nephrology and Hypertension Haifa

Co-author 2

Daniel Kushnir danielitto@clalit.org.il Carmel Medical Center Department of Nephrology and Hypertension Haifa

Co-author 3

Amnon Gil AmnonGil@clalit.org.il Carmel Medical Center Department of Nephrology and Hypertension Haifa

Co-author 4

Jerom Marcuson jerima@clalit.org.il Carmel Medical Center Department of Nephrology and Hypertension Haifa

Co-author 5

Oleg Sura OlegSu@clalit.org.il Carmel Medical Center Department of Nephrology and Hypertension Haifa

Co-author 6

Yasir Sanalla YasirSa@clalit.org.il Carmel Medical Center Department of Nephrology and Hypertension Haifa

Co-author 7

Yosef Shihada yosefshi@clalit.org.il Carmel Medical Center Department of Nephrology and Hypertension Haifa

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Prevalence of End Stage Renal Disease (ESRD) is increasing worldwide. In the last years, age at onset of dialysis treatment is also rising. Today more than 50% of patients in maintenance dialysis have a mean age more than 65. For the last 20 years the responsible for this increasing prevalence is the population aged 75 or more year- old. Mortality during dialysis of this subpopulation has been reported as high as 50% during the first 2 years of dialysis. Data about patients aged more than 80 is scarce and inconclusive. The aim of the work: characterize factors of mortality in new very old dialysis patients.

Methods

Retrospective study which included the files of all patients who did their first hemodialysis after the age of 80 between 1.1.2009- 30.11.2019.

Results

A total of 621 patients older than 80 begun dialysis treatment during the period. Mean age was 85 ± 4 years. Diabetes Mellitus was diagnosed in 52% of cases. Mean Charlson Score was 8.4. They have some degree of nursing status in 41% and dementia in 16%. During the period 84% of the patients died. Elective maintenance dialysis due to ESRD was started in 18%, in 14% because of Acute Kidney Injury and in 68% after Acute on Chronic Kidney Disease (CKD). A six months survival of over 80% was noted in the elective patients. In this group 99 patients aged 80-89 and 6 patients were over 90. Eighty percent of younger patients survived for at least 6 months but only 55% of the more than 90 year- old. Average survival was also longer in young patients (29.4 months) than in the older group (16.4 months). Survival inversely correlated with dementia. For patients which begun dialysis due to AKI, average survival was 14.9 months in young people, vs 3.3 month in patients aged 90 or more. Average survival time after Acute on CKD needing dialysis was 13.5 month in the 80-89 group and 6.3 months in 90+ people.

Conclusions

Prognosis of very old patients on hemodialysis is disappointing. Renal replacement therapy in this kind of patients is challenging requiring clear targets different from the younger population.

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