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Kidney Week

Abstract: TH-PO667

Risk Factors for Early Mortality Among Elderly Filipino Patients with Indications for Initiation of Hemodialysis: A Comparative Study

Session Information

  • Geriatric Nephrology
    November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

  • 1100 Geriatric Nephrology

Authors

  • Relampagos, Paul carlo Tagalog, San Pedro Hospital of Davao City, Davao City, Philippines
  • Togonon-Leaño, Jennifer Ivy, San Pedro Hospital of Davao City, Davao City, Philippines
Background

The worldwide incidence of kidney failure is rising. Globally, 5-10 million people die annually from kidney disease. In 2015, the Philippines reported a mortality rate of 3.9 per 100,000 population for kidney diseases.
Of the 32,077 Filipinos on dialysis in 2015, 18,603 were initiated within the same year. Most are 60 years old and older, diabetic, and have other co-morbid conditions. Because, dialysis is a high-cost treatment, the Philippines enforced the Universal Health Coverage Bill. However, Filipinos continue to bear the financial burden of hemodialysis. These issues along with the Filipino cultural context question the practicality of initiating hemodialysis among the elderly.
This study aims to identify factors significantly associated with early mortality and obtaining the early mortality rates among elderly Filipino patients initiated on hemodialysis and those who were not. To our knowledge, this is the first study of its kind on Filipinos.

Methods

This is a prospective, observational, cohort study. Dialysis-naïve elderly patients admitted from January to April 2019 in a tertiary hospital in the Philippines and were advised to initiate hemodialysis were enrolled. Demographic data and the presence of the following risk factors were obtained: diabetes mellitus, congestive heart failure, peripheral arterial disease, dysrhythmia, active malignancy, severe behavioral disorder, unplanned dialysis, hypoalbuminemia, ischemic heart disease, ventilator dependency, coma, sepsis, hepatic failure, COPD, BMI <18.5 kg/m2, and total dependency for transfers. Individual outcomes (death against survival) between the two groups (initiated on hemodialysis against those were not—refused or consented for but were not initiated on hemodialysis) will be followed until four months after their attending nephrologists advised hemodialysis.

Results

52 patients were enrolled in the study—52% initiated hemodialysis while 48% did not. Preliminary data shows more deaths among those initiated on hemodialysis (37%) than those who were not (32%). Risk factors identified among those initiated on hemodialysis and died include unplanned dialysis (100%), total dependency for transfers (83%), diabetes mellitus (67%), and hypoalbuminemia (67%).

Conclusion

The study is currently on its follow-up phase and will end by August 2019.