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Abstract: PO1204

Effects of Improvements in Nutritional and Physical Conditions on Life Prognosis in Elderly Hemodialysis Patients in Japan

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Kanda, Eiichiro, Kawasali Medical School, Kurashiki, Okayama, Japan
  • Kato, Akihiko, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
  • Tsuruta, Yuki, Tsuruta Itabashi Clinic, Itabashi, Tokyo, Japan
  • Kikuchi, Kan, Shimoochiai Clinic, Shinjuku, Tokyo, Japan
  • Kashihara, Naoki, Kawasali Medical School, Kurashiki, Okayama, Japan
  • Abe, Masanori, Nihon University School of Medicine, Itabashi, Tokyo, Japan
  • Masakane, Ikuto, Yabuki Hospital, Yamagata, Yamagata, Japan
  • Nitta, Kosaku, Tokyo Women’s Medical University, Shinjuku, Tokyo, Japan
  • Kanno, Yoshihiko, Tokyo Medical University, Shinjuku, Tokyo, Japan
Background

The increase in the number of elderly dialysis patients is an urgent worldwide issue. Among these patients, malnutrition and physical-function decline are often observed. Therefore, we conducted a nationwide cohort study using the elderly hemodialysis patient database (n=38227) of the Japanese Society for Dialysis Therapy to investigate the relationship of their nutritional and physical conditions with their risk of one-year death.

Methods

Malnutrition and poor performance status (PS) were defined as being indicated by low serum albumin levels, and high scores of the modified Eastern Cooperative Oncology Group PS, respectively. After a one-year follow-up of changes in these factors, the relationships between the changes in these factors and the risk of one-year death were evaluated using Cox proportional hazards models adjusted for baseline characteristics.

Results

Among the patients examined, 57.9% were males; age, 73.2±6.0 years; diabetes mellitus, 33.7%; serum albumin level, 3.7±0.3 g/dL. The prevalence of patients in the low-albumin/poor-PS group tended to increase with age: 65 to 69 years, 1.4%; 85 years or older, 22.7% (Figure A). The low-albumin/poor-PS group showed a higher risk of all-cause of death than the high-albumin/good-PS group: adjusted hazard ratio (aHR), 2.77 (95% CI, 2.24, 3.44) (Figure B). The 0.1 g/dL improvements in serum albumin levels and 1 point improvement in PS scores were independently associated with better life prognosis; aHR 0.93 (0.92, 0.95); aHR 0.76 (0.71, 0.81). These results were confirmed in subgroups categorized on the basis of age, and the presence of DM.

Conclusion

Malnutrition and PS decline are risk factors for death in elderly hemodialysis patients, and should be evaluated and treated simultaneously. It is expected that the treatments of patients with these factors will improve their life prognosis independent of their baseline characteristics.