Clinical Study
Long-term survival analysis of the elderly peritoneal dialysis patients
Yang Li, Haiyun Wang, Ying Wang, Zijuan Zhou, Bingyan Liu, Wei Yang, Ying Cui, Xuemei Li, Limeng Chen
Published 2017-01-15
Cite as Chin J Nephrol, 2017, 33(1): 1-7. DOI: 10.3760/cma.j.issn.1001-7097.2017.01.001
Abstract
ObjectiveTo analyze the clinical data of the elderly peritoneal dialysis (PD) patients in Peking Union Medical College Hospital (PUMCH), and to find the risk factors for the long-term survival.
MethodsBaseline data and the outcome of maintenance PD patients from 1996-03 to 2015-09-30 were collected for a retrospective cohort study. Patients were divided into the non-elderly group (<65 years old), the 65-79 years old group and the ≥80 years old group, and were follow to 2016-09-30. The survival rate was calculated by Kaplan-Meier method and the risk factors of outcome were analyzed by the Cox's regression model.
ResultsAmong 577 PD patients, about 243(42.1%) were elderly patients, including 207 patients aged between 65 and 79 years (35.9%) and 36 patients aged 80 or more (6.2%). The most common primary disease causing PD was diabetic nephropathy (DN) for both elderly and non-elderly patients. The 1-year, 3-year, 5-year survival rate of patients aged between 65 and 79 years were 87.0%, 61.9%, 32.4% respectively, and 72.5%, 48.5%, 27.3% for the ≥80 years old group. The dominating reasons of death were cardiovascular events and infection. There was no difference of technical survival rates among three groups, and the most common reason for technical failure was peritonitis. For elderly patients, diabetes (HR=2.193, 95% CI 1.445-3.328, P<0.001) and lower baseline serum albumin (HR=0.968, 95%CI 0.940-0.996, P=0.026) were independent risk factors for death. However, for non-elderly patients, diabetes (HR=3.746, 95%CI 2.149-6.529, P<0.001) was the only independent risk factor for death.
ConclusionsCardiovascular diseases and infection are the main reasons for death among the elderly PD patients in PUMCH. Diabetes and lower baseline serum albumin may predict the mortality of elderly PD patients independently. Better management of nutrition might improve survival in elderly PD patients.
Key words:
Peritoneal dialysis; Survival analysis; Aged
Contributor Information
Yang Li
Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &
Peking Union Medical College, Beijing 100730, China
Haiyun Wang
Ying Wang
Zijuan Zhou
Bingyan Liu
Wei Yang
Ying Cui
Xuemei Li
Limeng Chen