Cohort study with patients older than 80 years with stage 5 chronic kidney failure on hemodialysis vs conservative treatment: Survival outcomes and use of healthcare resources

Autor: Garcia Testal, Alicia, Garcia Maset, Rafael, Fornes Ferrer, Victoria, Cañada Martínez AJ, Fernandez Fandos, Sonia, Rico Salvador, Inmaculada S., Royo Maicas, Pilar, Carretero Lopez, Vanesa, Villalon Coca, Javier, Fernandez Najera, Jose E., Benedito Carrera, Caterina, Olague Diaz, Pau, Torregrosa De Juan, Eduardo
Rok vydání: 2021
Předmět:
Zdroj: THERAPEUTIC APHERESIS AND DIALYSIS
r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe
instname
ISSN: 1744-9979
Popis: Renal replacement treatment has not been generalized to the elderly for different reasons. The main objective of the present cohort study is to compare survival in patients older than 80 years with chronic kidney disease stage 5 on renal replacement treatment with those on conservative treatment. The use of healthcare resources is compared too. A Cox proportional hazards regression analysis was run with the outcome variable death during the follow-up period. The independent variables were treatment type, age, gender, smoking habit, serum albumin, hemoglobin, Charlson Index, diabetes mellitus, arterial hypertension, ischemic cardiopathy, and neoplasm. For outcome variable "death," renal replacement treatment obtained a hazard ratio of 0.273 (P .006, CI95% 0.108-0.686) vs conservative treatment. In conclusion, patients older than 80 years with chronic kidney disease stage 5 on renal replacement treatment presented a lower mortality risk than those receiving conservative treatment. Comorbidity and age are both associated with mortality, but do not cancel out the survival advantage. In healthcare resources, the renal replacement treatment group made greater use of tests, medical visits and consumption of hospital dispensing drugs, but there were no differences with respect to the days of hospital admission or assistance in home hospitalization.
Databáze: OpenAIRE
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