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Abstract: FR-PO449

One-Year Survival and Hospitalization After Dialysis Initiation in Patients Aged Above 75

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Saudan, Patrick, Service of Nephrology, Geneva University Hospitals, Geneva, Switzerland
  • Jaques, David Antoine, Service of Nephrology, Geneva University Hospitals, Geneva, Switzerland
  • Dufey Teso, Anne, Service of Nephrology, Geneva University Hospitals, Geneva, Switzerland
  • Haidar, Fadi, Service of Nephrology, Geneva University Hospitals, Geneva, Switzerland
  • Ponte, Belen, Service of Nephrology, Geneva University Hospitals, Geneva, Switzerland
  • Carballo, Sebastian, Service of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
  • De Seigneux, Sophie M., Service of Nephrology, Geneva University Hospitals, Geneva, Switzerland
Background

Implementation of dialysis in elderly patients is debated because of an unfavourable short-term prognosis. We therefore analyzed the one-year impact on survival of planned implementation versus emergency dialysis in this population.

Methods

All patients who started maintenance dialysis in our unit during the past 21 years were reviewed. Patient’s demographic and clinical characteristics were collected. Emergency implementation of maintenance dialysis was determined if there was no prior referral to a nephrologist one month before dialysis initiation.

Results

From 2000 to the end of 2021, 860 patients started maintenance dialysis in our unit, of whom 231 were aged 75 and above. Mean age was 80 + 4 years. Hemodialysis was implemented in 83 % of the patients. There were 66% male, 41 % diabetics and median eGFR at start of dialysis was 7+ 3 ml/mn. Emergency dialysis was implemented in 36% (n=81) of the patients aged 75 and above. One-year mortality was 18% in patients who had planned dialysis and 36% in patients with emergency dialysis. One-year mean survival was 327+12 days in patients with planned dialysis versus 275+ 21days in those who had emergency dialysis (p< 0.004). In multivariate analysis including age, gender, comorbidity score and dialysis modality, prior referral was associated with a 33% decline in one-year mortality (HR: 0.67; 95% CI. 048-0.93). Hospitalization-free days within the first year after dialysis start or death were 311+60 days in referred patients versus 280+ 74 days in those dialyzed in emergency (p< 0.005).

Conclusion

In our dialysis population, one-month referral to nephrologists prior to dialysis implementation significantly increased one-year survival and hospitalization-free days in ESKD patients aged above 75.