In:
Postępy Higieny i Medycyny Doświadczalnej, Walter de Gruyter GmbH, Vol. 71, No. 0 ( 2017-12-12), p. 0-0
Abstract:
Background: The survival rate of elderly hemodialyzed (HD) patients is commonly thought to be poor. In a prospective, single center, non-interventional, observational study, the cause of all-cause and cardiovascular (CV) and heart failure (HF) mortality in this patient group were examined and compared with a younger cohort (below 60 years).
Material/Methods: The study included 223 patients (90 women and 133 men) with age ranging from 34.5 to 75.0 years treated with HD. Median duration of HD was 70.0 months (24.0-120.0). Mortality data was collected over a period of six years. We divided patients into groups: 〈 60 (n=123), ≥60 years (n=100), and with (n=33) and without DM type 2 (n=190).
Results: During a six-year follow-up, 100 patients (44.8%) died, including 83 (37.2%) patients who died due to CV reasons. Median follow-up was 2015.0 days (946.0-2463.0) with the median time to death of 1166.0 days (654.5-1631.0). The factors negatively affecting patients’ survival in univariate Cox regression analysis included for all-cause mortality were: inter-dialytic weight gain (IDWG) (hazard ratio [HR] =1.60; p=0.01), ultrafiltration (UF) rate (HR=3.63; p=0.012) for group 〈 60 years; for CV death: UF rate (HR=4.20; p=0.03), DM (HR=5.11; p=0.002) for group 〈 60 years; for HF death: mellitus type 2 (DM) (HR=2.93; p=0.027) for group ≥60 years). In a multivariate Cox regression analysis for patients 〈 60 years, the UF rate was the only independent predictor of all-cause mortality (HR 3.63 (1.34-9.67); p=0.011). Both DM (HR 4.91 (1.71-14.10); p=0.003) and UF rate (HR 3.62 (1.04-12.61); p=0.044) were independent predictors of CV-related mortality in patients 〈 60 years.
Conclusions: The UF rate can be a simple, useful indicator of higher long-term all-cause and CV mortality in HD patients 〈 60 years of age. Also, DM may be a predictor of CV–related mortality in younger HD patients.
Type of Medium:
Online Resource
ISSN:
0032-5449
,
1732-2693
DOI:
10.5604/01.3001.0010.7010
Language:
English
Publisher:
Walter de Gruyter GmbH
Publication Date:
2017
detail.hit.zdb_id:
2150116-6
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