BACKGROUND: As Korea advances into the ageing society, the number of elderly person receiving dialysis has increased. Two-year survival rate of the patients who received hemodialysis was 84.2% in 1996. But there is no estimate on the survival rate of the patients over age 65. Elderly persons are more prone to have dialysis complications and have more problems in cardiovascular system. The following is a 5-year-study on the elderly ESRD patients who underwent hemodialysis. METHODS: In this retrospective study, 825 patients had received hemodialysis at Seoul Paik Hospital from Jan. 1997 to Dec. 2002. The elderly group was consisted of 35 patients over age 65 and the non-elderly group was consisted of 43 patients below age 65 who received hemodialysis. And they had been traced for more than six months. The patient`s age, sex, occupation and whether the patient was married or not, had been compiled. Also taken into consideration was etiology, complications, initial laboratory data, electrocardiography, abdominal sonography, echocardiography, ftmndus examination, cause of death. RESULTS: Average age of the elderly and the non-elderly group was 70.1 and 47.4 years(p<0.00). nd parathyroid hormone were different between the two groups(p<0.05), other laboratory data were not. Prevalence of diabetes mellitus and hypertensive nephrosclerosis were not either. The overall 1, 2, 5 year survival rate was 97.3%, 93.4%, 73.7%. And the 5-year survival rate was 88.6% in the non-elderly group and it was 54.1% in the elderly group(Kaplan-Meier method). Causes of death were sepsis(n=3), cerebrovas cular accident(n=2), myocardial infarction, pneumonia and gastrointestinal bleeding, malignancy, withdrawal of treatment(1 patient respectively) in the elderly group and were myocardial infarction, withdrawal of treatment in the non-elderly group(n=2). CONCLUSION: The 5-year survival rate of the elderly patients was lower than the non-elderly(p<0.001). The contributing factor of death was not etiology but cormobid condition according to ageing process and socioeconomic circumstance. In other words, it was cardiovascular disease, infection due to impaired immune system and withdrawal of treatment due to economic problems. So it would be necessary to monitor carefully these factors for the elderly hemodialysis patients to improve survival..
Aged* ; Cardiovascular Diseases ; Cardiovascular System ; Cause of Death ; Diabetes Mellitus ; Dialysis ; Echocardiography ; Electrocardiography ; Hemorrhage ; Humans ; Immune System ; Kidney Failure, Chronic ; Korea ; Myocardial Infarction ; Nephrosclerosis ; Occupations ; Parathyroid Hormone ; Pneumonia ; Prevalence ; Renal Dialysis* ; Retrospective Studies ; Seoul ; Survival Rate

Since the first case was diagnosed on May 20, 2015, there were 186 confirmed cases of Middle East Respiratory Syndrome (MERS) until the end of outbreak in South Korea. Although medical institutions were the most identifiable sources of MERS transmission in South Korea, similar to other countries, in-depth epidemiological investigation was required for some confirmed cases with indefinite contact history or hospital visit records. The subject of epidemiological investigation in the present study was a 35 year-old male patient diagnosed with MERS (#119) who lived in Asan-city and worked in Pyeongtaek-city. Various potential sources of transmission were carefully investigated. While he could have been exposed to MERS through a friend from Saudi Arabia or confirmed MERS cases in his workplace, neighboring areas, and medical institutions, as well as contacts in his home, the chances of transmission were low; however, the potential for transmission through his local community could not be excluded. Practically, it was difficult to determine the modes of transmission for all outbreak cases in communicable disease that occurred in this short period of time. The investigation to identify the mode of transmission in this case was ultimately unsuccessful. However, the various data collected and analyzed to reveal modes of transmission provided detailed information that could not be collected using only interview surveys.
Chungcheongnam-do ; Communicable Diseases ; Community-Acquired Infections ; Coronavirus* ; Disease Outbreaks ; Disease Transmission, Infectious ; Friends ; Gyeonggi-do* ; Humans ; Korea* ; Male ; Middle East* ; Republic of Korea ; Saudi Arabia