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In the last decade, there has been an increase in the number of elderly people in Brazil: from 2012 to 2017, the number of people in this subgroup increased by 4.8 million. In 2021, the life expectancy of Brazilians increased to 77 years. Similarly, there has been an increase in the number of patients with end-stage chronic kidney disease (CKD). According to data from the latest census of the Brazilian Society of Nephrology, the number of patients on dialysis increased by 3.6% in 2022 compared to 2021. The rate of elderly people who started dialysis in recent years was higher than that of young people. In addition to mortality, the decision to start dialysis treatment in elderly patients encompasses morbidity and especially quality of life, individual preferences, and shared decision. The improvement of clinical outcomes in elderly patients on dialysis is a challenge. The objective of this study was to evaluate the sociodemographic and clinical profile of elderly people in a dialysis unit located in northeastern Brazil.
A retrospective study was conducted using data collected from the system of a private hemodialysis service located in Aracaju-Sergipe, Brazil, from October 2019 to November 2023. Elderly patients (population aged 60 years or older, according to the Brazilian Elderly Statute) were included. The profile of sociodemographic (age, gender, race) and clinical (etiology of CKD and kidney transplantation) data was described, as well as data on hospitalizations and deaths.
The proportion of elderly patients undergoing hemodialysis is high, with a high number of hospitalizations and mortality, especially in those over 75 years of age. The study shows the imperative need for improvement in care in this subgroup of the elderly population. With the increase in life expectancy and consequently in the number of elderly people on dialysis, there is a need for policies to improve outcomes such as mortality, hospitalization and quality of life. Such policies should include better preparation for the initiation of dialysis treatment, discussions about renal support treatment and withdrawal from dialysis, measures to reduce hospitalization and increase the performance of kidney transplants in this population.