Kidney Week

Abstract: TH-PO933

Clinical Outcomes between Planned and Unplanned Hemodialysis in Elderly Patients

Session Information

• Geriatric Nephrology: Innovations and Insights
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

• 1300 Geriatric Nephrology

Authors

• Park, Woo Yeong, Division of Nephrology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea (the Republic of)

Woo Yeong Park, MD, PhD

• Cho, Jang-Hee, Division of Nephrology, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea (the Republic of)

Jang-Hee Cho, MD, PhD

• Yu, Byung chul, Division of Nephrology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea (the Republic of)

Byung chul Yu, MD, PhD

• Song, Sang Heon, Division of Nephrology, Department of Internal Medicine, Pusan National University Hospital, Busan, Korea (the Republic of)

Sang Heon Song, MD, PhD

• Yang, Jae Won, Division of Nephrology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)

Jae Won Yang, MD, PhD

• Chung, Sungjin, Division of Nephrology, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Korea (the Republic of)

Sungjin Chung, MD, PhD, FASN

• Hyun, Young Youl, Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)

Young Youl Hyun, MD, PhD

• Bae, Eunjin, Division of Nephrology, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea (the Republic of)

Eunjin Bae, PhD

• Sun, In O, Division of Nephrology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea (the Republic of)

In O Sun, MD, PhD

• Kim, Hyunsuk, Division of Nephrology, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea (the Republic of)

Hyunsuk Kim, MD, PhD

• Hwang, Won Min, Division of Nephrology, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea (the Republic of)

Won Min Hwang, MD, PhD

• Shin, Sung Joon, Division of Nephrology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University School of Medicine, Goyang, Korea (the Republic of)

Sung Joon Shin, MD, PhD

• Kwon, Soon hyo, Division of Nephrology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea (the Republic of)

Soon hyo Kwon, MD

• Yoo, Kyung Don, Division of Nephrology, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea (the Republic of)

Kyung Don Yoo, MD, PhD

• Hong, Yu Ah, Division of Nephrology, Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Daejeon, Korea (the Republic of)

Yu Ah Hong, MD, PhD

Group or Team Name

• The Korean Society of Geriatric Nephrology (KSGN).

Background

The initial mortality rate of hemodialysis (HD) is high in elderly patients with end-stage renal disease (ESRD). However, the clinical outcomes between unplanned and planned HD treatment among them and prognostic factors are not clear.

Methods

We analyzed 2,373 patients aged ≥70 years starting HD. We investigated patient survivals between unplanned and planned HD in elderly ESRD patients and risk factors for mortality.

Results

Unplanned HD patients were older, had a higher dementia, congestive heart failure (CHF) and activities of daily living dependency, lower BMI, hemoglobin, albumin, hypertension and diabetes. However, there were no significant differences in the proportion of ischemic heart disease, cerebrovascular accident, in the hospitalization history prior to HD initiation between planned and unplanned HD. The proportions of catheter use at dialysis initiation and maintenance vascular access were significantly higher in the unplanned HD patients than in the planned HD patients. In Kaplan-Meier analysis, unplanned HD patients showed significantly lower patient survival rate than planned HD patients. In multivariate cox regression analysis, male, older age at dialysis initiation, lower BMI, CHF, uncontrolled malignancy, lower activities of daily living dependency, hospitalization prior to HD, catheter use as a maintenance vascular access and lower serum albumin level were significantly associated with a higher risk of all-cause mortality.

Conclusion

In elderly ESRD patients, unplanned HD using catheter as maintenance dialysis has a poor prognosis, so it is necessary to plan the appropriate vascular access in elderly patients.

Patient survival between planned and unplanned hemodialysis

Funding

• Government Support – Non-U.S.