Survival analysis of hemodialysis patients aged 80 years and over
10.3760/cma.j.issn.0254-9026.2020.05.017
- VernacularTitle:高龄老年血液透析患者的生存分析
- Author:
Zhigui ZHENG
1
;
Dongyuan HE
;
Yifang CHEN
;
Jianguo CHEN
Author Information
1. 浙江医院肾内科，杭州 310013
- From:
Chinese Journal of Geriatrics
2020;39(5):559-563
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the long-term survival rate and the influencing factors for prognosis in patients aged 80 years and over who underwent hemodialysis.Methods:Clinical data of 82 patients with end stage renal disease (ESRD) who started dialysis in≥80 years of age and underwent hemodialysis for more than three months in our hospital from May 2008 to May 2017 were retrospectively analyzed.Kaplan-Meier method was used to analyze the survival rate of patients.Log-rank test was used to compare survival rate of hemodialysis patients aged≥80 years versus aged<80 years.Cox regression model was performed to analyze the influencing factors for prognosis in elderly patients undergoing hemodialysis.Results:The median survival time of 82 hemodialysis patients aged≥80 years was 34 months, and their 6-month, 12-month, 24-month and 36-month survival rates were 90.0%, 73.6%, 60.8% and 49.4%, respectively.The top three death causes were cardiovascular events, septic shock, and malignant tumors.The median survival time of the hemodialysis patients aged<80 years was 52 months, and their 6-month, 12-month, 24-month and 36-month survival rates were 94.7%, 85.5%, 72.4% and 65.8%, respectively.Log-rank test demonstrated that the survival rate was lower in patients aged≥80 years than in patients aged<80 years( χ2=5.284, P=0.022). Multivariate Cox regression analysis indicated that diabetes mellitus was an independent risk factor for the survival in hemodialysis patients aged≥80 years( HR=3.470, 95% CI: 1.364~8.827, P=0.009), while targeted levels of body mass index(BMI)( HR=0.806, 95% CI: 0.706~0.921, P=0.001)and serum albumin level( HR=0.861, 95% CI: 0.789~0.938, P=0.001)were the independent protective factors for the survival in hemodialysis patients aged≥80 years. Conclusions:The survival rate is lower in hemodialysis patients aged≥80 years than in those aged<80 years.The top death causes is cardiovascular events, septic shock, and malignant tumors.Diabetes mellitus, low levels of BMI and serum albumin are the main risk factors for the survival in advanced elderly patients undergoing hemodialysis.
