Effect of age and diagnosis on survival of older patients beginning chronic dialysis

C. Byrne, P. Vernon and J. J. Cohen
New York State Department of Health, Stony Brook.

OBJECTIVE--To assess the survival of elderly patients in the United States beginning chronic dialysis for end-stage renal disease caused by diabetes mellitus, hypertension, glomerulonephritis, polycystic kidney disease, and other causes. DESIGN--A secondary analysis of data obtained from the Health Care Financing Administration. PATIENTS--All Medicare end-stage renal disease patients 55 years of age or older (n = 95,394) who began chronic dialysis treatment in the US between 1982 and 1987. MAIN OUTCOME MEASURES--The 1-, 3-, and 5-year survival rates for each of six age strata and, within each strata, for each of the four most frequent causes of renal failure. RESULTS--Survival rates of dialysis patients fell precipitously, and much more rapidly for the study group than for the general population, as a function of advancing age. Older patients with diabetic nephropathy fared particularly badly, such that no patients with diabetic nephropathy aged 85 years or more survived 5 years. CONCLUSIONS--Mortality rates of patients older than 55 years beginning chronic dialysis treatment increased dramatically as age at initiation of dialysis increased. Clinically meaningful survival data should prove useful to persons making decisions about the initiation of chronic dialysis.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Comorbidities in UK patients at the start of renal replacement therapy (Chapter 6)
Tomson et al.
Nephrol Dial Transplant 2007;22:vii58-vii68.
ABSTRACT | FULL TEXT  

Renal Artery Stenosis: Cost-effectiveness of Diagnosis and Treatment
van Helvoort-Postulart et al.
Radiology 2007;244:505-513.
ABSTRACT | FULL TEXT  

Soluble CD154 Is a Unique Predictor of Nonfatal and Fatal Atherothrombotic Events in Patients Who Have End-Stage Renal Disease and Are on Hemodialysis
Hocher et al.
J. Am. Soc. Nephrol. 2007;18:1323-1330.
ABSTRACT | FULL TEXT  

Analysis of Outcomes for Surgically Treated Hip Fractures in Patients Undergoing Chronic Hemodialysis
Karaeminogullari et al.
JBJS 2007;89:324-331.
ABSTRACT | FULL TEXT  

Targeting screening mammography according to life expectancy among women undergoing dialysis.
Walter et al.
Arch Intern Med 2006;166:1203-1208.
ABSTRACT | FULL TEXT  

Valve Replacement Surgery in End-Stage Renal Failure: Mechanical Prostheses Versus Bioprostheses.
Chan et al.
Ann. Thorac. Surg. 2006;81:857-862.
ABSTRACT | FULL TEXT  

Different Impact of Biomarkers as Mortality Predictors among Diabetic and Nondiabetic Patients Undergoing Hemodialysis
Hocher et al.
J. Am. Soc. Nephrol. 2003;14:2329-2337.
ABSTRACT | FULL TEXT  

Octogenarians Reaching End-Stage Renal Disease: Cohort Study of Decision-Making and Clinical Outcomes
Joly et al.
J. Am. Soc. Nephrol. 2003;14:1012-1021.
ABSTRACT | FULL TEXT  

Outcome of renal replacement therapy in the very elderly
Munshi et al.
Nephrol Dial Transplant 2001;16:128-133.
ABSTRACT | FULL TEXT  

Cardiac Troponin T Predicts Mortality in Patients With End-Stage Renal Disease
Dierkes et al.
Circulation 2000;102:1964-1969.
ABSTRACT | FULL TEXT  

Cardiac valve replacement in patients on dialysis: influence of prosthesis on survival
Kaplon et al.
Ann. Thorac. Surg. 2000;70:438-441.
ABSTRACT | FULL TEXT  

Results of Valve Replacement With Mechanical and Biological Prostheses in Chronic Renal Dialysis Patients
Lucke et al.
Ann. Thorac. Surg. 1997;64:129-132.
ABSTRACT | FULL TEXT  

Debility, unspecified: A terminal diagnosis
Kinzbrunner et al.
AM J HOSP PALLIAT CARE 1996;13:38-44.
ABSTRACT  

ELDERLY PATIENTS FARE POORLY ON DIALYSIS
JWatch General 1994;1994:1-1.
FULL TEXT