Epidemiology and Demographic Aspects of Treated End‐Stage Renal Disease in the Elderly

Krishnan, Murali; Lok, Charmaine E.; Jassal, Sarbjit V.

doi:10.1046/j.1525-139x.2002.00028.x

Cited by 39 publications

(30 citation statements)

References 14 publications

(16 reference statements)

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“…Survival at 1 year was similar to that seen in our study; however, further data are not available because of the limited follow-up. Other studies have shown shorter survival among older patients than among younger patients, even after correction for multiple comorbid conditions, [10][11][12][13][14] although few compared survival over time for a specific age group, as we did. Our finding of improved survival over time is in contrast to that from a recent study in the United States involving patients aged 80 years or older at the start of dialysis.…”

mentioning

confidence: 54%

Changes in survival among elderly patients initiating dialysis from 1990 to 1999

Jassal¹,

Trpeski²,

Zhu³

et al. 2007

Canadian Medical Association Journal

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mentioning

confidence: 54%

Changes in survival among elderly patients initiating dialysis from 1990 to 1999

Jassal¹,

Trpeski²,

Zhu³

et al. 2007

Canadian Medical Association Journal

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“…Centers that are expert in one form of dialysis only cannot present the patient with all his/ her options because, of necessity, they will emphasize the option with which they are most familiar. Also, in presenting the various dialysis options to new patients, physicians and other health-care professionals must avoid imposing their own biases on their patients [2]. Although several surveys indicate that nephrologists agree that we make excessive use of incenter HD, they also regard many factors to be contra-indications to PD [1,2].…”

Section: Introductionmentioning

confidence: 99%

Home dialysis as a first option: a new paradigm

et al. 2009

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Traditionally, the initial choice of dialysis for patients with end stage renal disease (ESRD) has been in-center hemodialysis (HD) or peritoneal dialysis (PD). Usually, the choice between these (PD vs. HD) has been based on the characteristics of the dialysis techniques. Obviously the choice of peritoneal dialysis implied dialysis at home, but its geographic location has been only a secondary consideration. Peritoneal dialysis has evolved as a dependable mode that gives good outcomes. This method has become more attractive with the option of overnight cyclers and the recent use of home helpers in some jurisdictions. At the same time the interest in home hemodialysis was rekindled by reports of good outcomes with short daily or nocturnal hemodialysis. Home dialysis (PD or HD) offers high quality of treatment, a high degree of patient independence, and is financially attractive. Therefore, we propose a change in our approach to the choice of the initial form of dialysis for patients with ESRD. Instead of choosing between HD and PD we should present the new patients the advantage of dialysis at home and instead of asking them to choose between peritoneal dialysis or hemodialysis, they should be offered the option to choose between dialysis at home (PD or HD) or in-hospital. This paper will review the advantages of the home-based dialysis methods and the arguments for this simple but vital change in the process of choosing the method of dialysis.

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“…Increased longevity, coupled with technical advances and heightened public expectation, has contributed to an unprecedented increase in demand for dialysis therapies in older age groups (2). The burden of comorbid disease is higher in this group of patients (4) and has been clearly shown to affect survival (5). For a select group of elderly patients with a heavy burden of comorbid illness, although dialysis may be technically feasible, the short-term mortality is often very high, particularly in those with advanced cardiovascular disease and/or diabetes (6).…”

mentioning

confidence: 99%

Is Maximum Conservative Management an Equivalent Treatment Option to Dialysis for Elderly Patients with Significant Comorbid Disease?

Carson

Juszczak

Davenport

et al. 2009

Clinical Journal of the American Society of Nephrology

401

388

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Background and objectives: There is ongoing growth of elderly populations with ESRD in Western Europe and North America. In our center, we offer an alternative care pathway of 'maximum conservative management' (MCM) to patients who elect not to start dialysis, often because of a heavy burden of comorbid illness and advanced age. The objective of our study was to compare clinical outcomes for patients who had ESRD and chose either MCM or renal replacement therapy (RRT).Design, setting, participants, & measurements: This is an observational study of a single-center cohort in the United Kingdom that evaluating 202 elderly (>70 yr) patients who had ESRD and had chosen either MCM (n ‫؍‬ 29) or RRT (n ‫؍‬ 173). We report survival, hospitalization rates, and location of death for this cohort. Survival was measured from a standardized 'threshold' estimated GFR of 10.

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Epidemiology and Demographic Aspects of Treated End‐Stage Renal Disease in the Elderly

Cited by 39 publications

References 14 publications

Changes in survival among elderly patients initiating dialysis from 1990 to 1999

Changes in survival among elderly patients initiating dialysis from 1990 to 1999

Home dialysis as a first option: a new paradigm

Is Maximum Conservative Management an Equivalent Treatment Option to Dialysis for Elderly Patients with Significant Comorbid Disease?

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