Renal replacement therapy in the over-80s

F. Ronsberg, C. G. Isles, K. Simpson, Gordon James Prescott

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: the incidence of chronic renal failure rises dramatically with age, which is no longer seen as a contraindication to treatment.

Aim: to characterise Scottish dialysis patients aged 80 years and over at the time of their first treatment and to compare their outcomes with those of patients with other serious illnesses.

Design and methods: retrospective survey of all older patients starting dialysis in Dumfries and Galloway between 1 January 1994 and 31 December 2003, and of all older chronic renal failure patients starting dialysis in Scotland between 1 January 1994 and 31 December 2001. Comparison with 4,565 Scottish Lung Cancer and 14,398 myocardial infarction (MI) patients of similar age.

Results: 213/3,944 Scottish dialysis patients were aged 80 years or over at the time of their first treatment, representing 5.4% of all new patients and 9.2% of all new starts in 2001. Ninety per cent of older patients received haemodialysis as their first mode of renal replacement therapy. The most common diagnosis was chronic renal failure of unknown cause in 41% of cases. Quality of life, measured in a subset of Dumfries patients, suggested similar social functioning and mental health, but poorer physical health than their younger dialysis counterparts. Early mortality was high in all three diagnostic groups. Median survival from 90 days after the start of treatment, registration or hospital admission was 459 days (95% CI, 375, 543) for the older Scottish CRF patients, compared to 141 days (128, 154) for lung cancer and 1242 days (1192, 1292) for MI patients.

Conclusions: dialysis can be an effective treatment modality for at least a proportion of octogenarians with end-stage renal failure.

Original languageEnglish
Pages (from-to)148-152
Number of pages4
JournalAge and Ageing
Volume34
Issue number2
DOIs
Publication statusPublished - 2005

Keywords

  • renal replacement therapy
  • chronic kidney failure
  • dialysis
  • older people and outcomes
  • elderly
  • QUALITY-OF-LIFE
  • ELDERLY DIALYSIS PATIENTS
  • CLINICAL-OUTCOMES
  • NEPHROLOGY
  • SURVIVAL
  • DISEASE
  • COHORT
  • AGE
  • REHABILITATION
  • HEMODIALYSIS

Cite this

Renal replacement therapy in the over-80s. / Ronsberg, F.; Isles, C. G.; Simpson, K.; Prescott, Gordon James.

In: Age and Ageing, Vol. 34, No. 2, 2005, p. 148-152.

Research output: Contribution to journalArticle

Ronsberg, F, Isles, CG, Simpson, K & Prescott, GJ 2005, 'Renal replacement therapy in the over-80s', Age and Ageing, vol. 34, no. 2, pp. 148-152. https://doi.org/10.1093/ageing/afi024
Ronsberg, F. ; Isles, C. G. ; Simpson, K. ; Prescott, Gordon James. / Renal replacement therapy in the over-80s. In: Age and Ageing. 2005 ; Vol. 34, No. 2. pp. 148-152.
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abstract = "Background: the incidence of chronic renal failure rises dramatically with age, which is no longer seen as a contraindication to treatment.Aim: to characterise Scottish dialysis patients aged 80 years and over at the time of their first treatment and to compare their outcomes with those of patients with other serious illnesses.Design and methods: retrospective survey of all older patients starting dialysis in Dumfries and Galloway between 1 January 1994 and 31 December 2003, and of all older chronic renal failure patients starting dialysis in Scotland between 1 January 1994 and 31 December 2001. Comparison with 4,565 Scottish Lung Cancer and 14,398 myocardial infarction (MI) patients of similar age.Results: 213/3,944 Scottish dialysis patients were aged 80 years or over at the time of their first treatment, representing 5.4{\%} of all new patients and 9.2{\%} of all new starts in 2001. Ninety per cent of older patients received haemodialysis as their first mode of renal replacement therapy. The most common diagnosis was chronic renal failure of unknown cause in 41{\%} of cases. Quality of life, measured in a subset of Dumfries patients, suggested similar social functioning and mental health, but poorer physical health than their younger dialysis counterparts. Early mortality was high in all three diagnostic groups. Median survival from 90 days after the start of treatment, registration or hospital admission was 459 days (95{\%} CI, 375, 543) for the older Scottish CRF patients, compared to 141 days (128, 154) for lung cancer and 1242 days (1192, 1292) for MI patients.Conclusions: dialysis can be an effective treatment modality for at least a proportion of octogenarians with end-stage renal failure.",
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AU - Isles, C. G.

AU - Simpson, K.

AU - Prescott, Gordon James

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N2 - Background: the incidence of chronic renal failure rises dramatically with age, which is no longer seen as a contraindication to treatment.Aim: to characterise Scottish dialysis patients aged 80 years and over at the time of their first treatment and to compare their outcomes with those of patients with other serious illnesses.Design and methods: retrospective survey of all older patients starting dialysis in Dumfries and Galloway between 1 January 1994 and 31 December 2003, and of all older chronic renal failure patients starting dialysis in Scotland between 1 January 1994 and 31 December 2001. Comparison with 4,565 Scottish Lung Cancer and 14,398 myocardial infarction (MI) patients of similar age.Results: 213/3,944 Scottish dialysis patients were aged 80 years or over at the time of their first treatment, representing 5.4% of all new patients and 9.2% of all new starts in 2001. Ninety per cent of older patients received haemodialysis as their first mode of renal replacement therapy. The most common diagnosis was chronic renal failure of unknown cause in 41% of cases. Quality of life, measured in a subset of Dumfries patients, suggested similar social functioning and mental health, but poorer physical health than their younger dialysis counterparts. Early mortality was high in all three diagnostic groups. Median survival from 90 days after the start of treatment, registration or hospital admission was 459 days (95% CI, 375, 543) for the older Scottish CRF patients, compared to 141 days (128, 154) for lung cancer and 1242 days (1192, 1292) for MI patients.Conclusions: dialysis can be an effective treatment modality for at least a proportion of octogenarians with end-stage renal failure.

AB - Background: the incidence of chronic renal failure rises dramatically with age, which is no longer seen as a contraindication to treatment.Aim: to characterise Scottish dialysis patients aged 80 years and over at the time of their first treatment and to compare their outcomes with those of patients with other serious illnesses.Design and methods: retrospective survey of all older patients starting dialysis in Dumfries and Galloway between 1 January 1994 and 31 December 2003, and of all older chronic renal failure patients starting dialysis in Scotland between 1 January 1994 and 31 December 2001. Comparison with 4,565 Scottish Lung Cancer and 14,398 myocardial infarction (MI) patients of similar age.Results: 213/3,944 Scottish dialysis patients were aged 80 years or over at the time of their first treatment, representing 5.4% of all new patients and 9.2% of all new starts in 2001. Ninety per cent of older patients received haemodialysis as their first mode of renal replacement therapy. The most common diagnosis was chronic renal failure of unknown cause in 41% of cases. Quality of life, measured in a subset of Dumfries patients, suggested similar social functioning and mental health, but poorer physical health than their younger dialysis counterparts. Early mortality was high in all three diagnostic groups. Median survival from 90 days after the start of treatment, registration or hospital admission was 459 days (95% CI, 375, 543) for the older Scottish CRF patients, compared to 141 days (128, 154) for lung cancer and 1242 days (1192, 1292) for MI patients.Conclusions: dialysis can be an effective treatment modality for at least a proportion of octogenarians with end-stage renal failure.

KW - renal replacement therapy

KW - chronic kidney failure

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KW - older people and outcomes

KW - elderly

KW - QUALITY-OF-LIFE

KW - ELDERLY DIALYSIS PATIENTS

KW - CLINICAL-OUTCOMES

KW - NEPHROLOGY

KW - SURVIVAL

KW - DISEASE

KW - COHORT

KW - AGE

KW - REHABILITATION

KW - HEMODIALYSIS

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DO - 10.1093/ageing/afi024

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SP - 148

EP - 152

JO - Age and Ageing

JF - Age and Ageing

SN - 0002-0729

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