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Abstract: FR-PO662

Factors Affecting Selection of Dialysis Modality in Elderly Patients with CKD: Prospective Cohort Study of Korea

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Cho, Jang-Hee, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
  • Jung, Hee-Yeon, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
  • Choi, Ji-Young, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
  • Park, Sun-Hee, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
  • Kim, Chan-Duck, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
  • Yoon, Se-Hee, Konyang University Hospital, Daejeon, Korea (the Republic of)
  • Kim, Yong-Lim, Kyungpook National University Hospital, Daegu, Korea (the Republic of)

Group or Team Name

  • Clinical Research Center for End Stage Renal Disease (CRC for ESRD) Investigators
Background

Several factors associated with dialysis modality selection have been reported in many studies. However, the factors affecting selection of dialysis modality in elderly patients with chronic kidney disease is not known. We investigated which factors are associated with selection of dialysis modality in elderly patients compared to younger patients.

Methods

This study included 2,238 incident dialysis patients from a multicenter prospective cohort study in Korea from August 2008 to July 2015 (NCT00931970). We surveyed demographic, referral, dialysis planning, socioeconomic, and clinical data. Using multivariate regression analyses, variables significantly associated with the chosen dialysis modality were analyzed. The differences in the factors were compared between elderly (≥65 years) and younger (<65 years) groups.

Results

Of the enrolled patients, 1,537 (68.7%) and 701 (31.3%) selected hemodialysis (HD) and peritoneal dialysis (PD) respectively. The percentage of HD was higher in elderly patients compared to younger patients (82.3% vs. 62.2%, p<0.001). In elderly group, patients choosing PD was younger than patients choosing HD (70.4±4.4 vs. 72.2±5.4, p<0.001). Patients with planned dialysis (p<0.001), employed status (p=0.042), married status (p=0.023), and congestive heart failure (p=0.003) were more common in elderly PD patients. However, patients with tumor were more common in elderly HD patients. Multivariate analysis showed that planned dialysis (p<0.001) and congestive heart failure (p=0.003) were independent factors for selecting PD and tumor (p=0.01) was for selecting HD in elderly group. In younger group, planned dialysis (p<0.001), employed status (p<0.001), and independent economic status (p=0.043) were revealed as the independent factors for choosing PD whereas peripheral vascular disease (p=0.019) and tumor (p=0.02) were independent factors for choosing HD.

Conclusion

As age of patients with chronic kidney disease increases, HD was more frequently selected modality than PD. Dialysis planning and specific comorbidities were associated with selection of dialysis modality in elderly patients. However, elderly patients were less affected by socioeconomic status compared to younger patients.