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Nefrología (Madrid)

versión On-line ISSN 1989-2284versión impresa ISSN 0211-6995

Resumen

MARTINEZ ECHEVERS, Yeleine et al. Survival of patients ≥70 years with advanced chronic kidney disease: Dialysis vs. conservative care. Nefrología (Madr.) [online]. 2016, vol.36, n.3, pp.283-291. ISSN 1989-2284.  http://dx.doi.org/10.1016/j.nefro.2015.11.006.

Introduction:

The number of elderly patients with advanced chronic kidney disease (ACKD) has increased in recent years, and the best therapeutic approach has not been determined due to a lack of evidence.

Objectives:

To observe the progression of elderly patients with ACKD (stages 4 and 5) and to compare the survival of stage 5 CKD patients with and without dialysis treatment.

Material and methods:

All patients ≥70 years who began ACKD follow-up from 01/01/2007 to 31/12/2008 were included, and their progression was observed until 31/12/2013. Demographic data, the Charlson comorbidity index, history of ischaemic heart disease (IHD) and diabetes mellitus (DM) were assessed.

Results:

A total of 314 patients ≥70 years with stages 4 and 5 CKD were studied. Of these patients, 162 patients had stage 5 CKD at the beginning of follow-up or progressed to stage 5 during the study, and 69 of these patients were treated with dialysis. In the stage 5 group: median age was 77 years (74-81); 48% had IHD; 50% had DM, Charlson 7 (6-9). Kaplan-Meier survival analysis: ≥70 years (93 vs. 69 patients with dialysis, log rank: 15 P < .001); patients ≥75 years (74 vs. 46 patients with dialysis, log rank: 8.9 P = .003); patients ≥80 (40 vs. 15 patients with dialysis) and p = 0,2. Patients receiving dialysis were younger, with a lower Charlson comorbidity index and shorter follow-up time.

Conclusions:

Our study shows that dialysis treatment improves survival, although this benefit is lost in patients ≥80 years.

Palabras clave : Advanced chronic kidney disease; Elderly; Survival; Conservative care; Frail patient.

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