Chronic Haemodialysis therapy in octogenarians with ESRF: demographics and outcomes from a single centre in England Dr Punit Yadav Dr Jyoti Baharani

HD vs. non-dialytic management Is maximum conservative management an equivalent treatment option to dialysis for elderly patients with significant comorbid disease? CJAN, Carson et el Dialysis prolongs survival for elderly patients who have ESRD with significant co morbidity by approximately 2yr Choosing not to dialyse: evaluation of planned non-dialytic management in a cohort of patients with end-stage renal failure, Smith et el In high-risk, highly dependent patients with renal failure, the decision to dialyse or not has little impact on survival Dialysis or not? A comparative survival study of patients over 75 years with chronic kidney disease stage 5, Murtagh et el Choosing dialysis rather than conservative management is associated with better survival in patients aged >75 years with advanced CKD Conservatively managed patients with stage 5 chronic kidney disease—outcomes from a single centre experience, Ellam et el Patients known to a nephrologist before reaching CKD 5 survived longer (median 32 months) than those presenting with CKD 5.

Aims and Methods Describe patient characteristics & associated co-morbidity at time of starting HD Outcome of octogenarians on HD programme in HEFT

Methods Retrospective electronic record survey of all patients aged 80 years or above commencing haemodialysis for ESRF in a single centre from 1992 to 2010 (18 years)

Data collected on  patient demographics  underlying cause of ESRF  total duration on haemodialysis  co-morbidity at time of commencing RRT (Charlson Index)  outcome of patients at 12 months  cause of death

Results N=177, Mean age 83.4 yrs, M:F ratio 1.5:1

2 decades of data Mean age for commencing HD was no different pre or post 2001

Number of pts known to Renal team prior to commencing HD

HD: access on commencing RRT

Aetiology of ESRD

Adjusted Charlson score (med/high group)

12 month mortality in high risk score group

12 month mortality

Cause of death

Conclusion Number of elderly patients on HD has increased over time Most octogenarians on HD have significant co- morbidity Improved survival in spite of more sick patients being included in HD programme

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