Effect of comorbidities on survival in patients >80 years of age at onset of renal replacement therapy: data from the ERA-EDTA Registry.

Autor:	Helve J; Finnish Registry for Kidney Diseases, Helsinki, Finland.; Abdominal Center Nephrology, University of Helsinki, Helsinki University Hospital, Helsinki, Finland., Kramer A; Department of Medical Informatics, ERA-EDTA Registry, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands., Abad Diez JM; Renal Registry of Aragon, Aragon Health Service, Zaragoza, Spain., Aresté-Fosalba N; Department of Nephrology, University Hospital Virgen Macarena, Seville, Spain.; Information System of the Autonomic Transplant Coordination of Andalucía (SICATA), Andalucía, Spain., Arici M; Department of Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Turkey., Cases A; Department of Nephrology, Hospital Clinic, Universitat de Barcelona, IDIBAPS, Barcelona, Spain.; Registre de Malalts Renals de Catalunya, Barcelona, Spain., Collart F; French-Belgian ESRD Registry (GNFB), Brussels, Belgium., Heaf J; Department of Medicine, Zealand University Hospital, Roskilde, Denmark., De Meester J; Department of Nephrology, Dialysis and Hypertension, Dutch-speaking Belgian Renal Registry (NBVN), Sint-Niklaas, Belgium., Nordio M; Veneto Dialysis and Transplantation Registry, Regional Epidemiology System, Padua, Italy.; Nephrology Dialysis Unit, Padua, Italy., Palsson R; Division of Nephrology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.; Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland., Pobes A; Area Gestation Clinica Nefrología VII-VIII Asturias, Spain., Rydell H; Department of Clinical Sciences Intervention and Technology, Karolinska Institutet, Huddinge, Sweden.; Department of Internal Medicine, Swedish Renal Registry, Ryhoy County Hospital, Jönköping, Sweden., Reisæter AV; Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway., Massy ZA; Division of Nephrology, Amboise Paré University Hospital, APHP, Boulogne-Billancourt, Paris, France.; Institut National de la Santé et de la Recherche Médicale (INSERM) Unit 1018 team5, Research Centre in Epidemiology and Population Health (CESP), University of Paris Ouest-Versailles-St Quentin-en-Yveline, Villejuif, France., Jager KJ; Department of Medical Informatics, ERA-EDTA Registry, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands., Finne P; Finnish Registry for Kidney Diseases, Helsinki, Finland.; Abdominal Center Nephrology, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
Jazyk:	angličtina
Zdroj:	Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [Nephrol Dial Transplant] 2021 Mar 29; Vol. 36 (4), pp. 688-694.
DOI:	10.1093/ndt/gfaa278
Abstrakt:	Background: The number of elderly patients on renal replacement therapy (RRT) is increasing. The survival and quality of life of these patients may be lower if they have multiple comorbidities at the onset of RRT. The aim of this study was to explore whether the effect of comorbidities on survival is similar in elderly RRT patients compared with younger ones. Methods: Included were 9333 patients ≥80 years of age and 48 352 patients 20-79 years of age starting RRT between 2010 and 2015 from 15 national or regional registries submitting data to the European Renal Association-European Dialysis and Transplantation Association Registry. Patients were followed until death or the end of 2016. Survival was assessed by Kaplan-Meier curves and the relative risk of death associated with comorbidities was assessed by Cox regression analysis. Results: Patients ≥80 years of age had a greater comorbidity burden than younger patients. However, relative risks of death associated with all studied comorbidities (diabetes, ischaemic heart disease, chronic heart failure, cerebrovascular disease, peripheral vascular disease and malignancy) were significantly lower in elderly patients compared with younger patients. Also, the increase in absolute mortality rates associated with an increasing number of comorbidities was smaller in elderly patients. Conclusions: Comorbidities are common in elderly patients who enter RRT, but the risk of death associated with comorbidities is less than in younger patients. This should be taken into account when assessing the prognosis of elderly RRT patients. (© The Author(s) 2021. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.)
Databáze:	MEDLINE
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