The interaction analysis between advanced age and longer dialysis vintage on the survival of patients receiving maintenance hemodialysis

Abstract

Objective To compare the all-cause mortality of aged and younger patients undergoing maintenance hemodialysis (MHD) over the long or short term, and to identify independent risk factors. Methods We performed a retrospective cohort study using the medical records of 181 patients undergoing MHD. We compared the clinical characteristics and laboratory data of survivors and participants who died, according to their age and the duration of MHD. Binary stepwise logistic regression was used to identify independent risk factors for all-cause mortality. Results Cardiovascular and cerebrovascular diseases were the principal causes of mortality. The number of aged participants with hypertensive nephropathy as their primary kidney disease was significantly higher than the number of younger participants. The proportion with chronic glomerulonephritis was significantly higher for participants undergoing long-term MHD. Logistic regression analysis revealed that low body mass index, single-pool Kt/V, serum albumin, platelet count, and total iron-binding capacity; and high intact parathyroid hormone and N terminal pro B type natriuretic peptide were independent risk factors for all-cause mortality. Conclusions Aged patients are more susceptible to hypertensive nephropathy than younger patients. In addition, the survival of patients with chronic glomerulonephritis undergoing MHD is superior to that of those with hypertensive or diabetic nephropathy.

Gender Differences in Chronic Kidney Disease. Findings from a Two Center Study in Nigeria

“…Higher blood pressures in males, with or without metabolic syndrome, could further worsen CKD outcomes in males [31]. However, the fairer biochemical findings in men in this study are supportive of studies that found the leveling of the cardiovascular risk between men and women in the first post-menopausal decade, before the reported relative increase in female CVS risk profile afterward [4,32,33].…”

Prevalence and current approaches to the treatment of secondary hyperparathyroidism and its complications in chronic kidney disease: a literature review

“…Показатели ССО (на 100 пациенто-лет) остаются самыми высокими в Северной Америке по сравнению с Европой и азиатскими странами -19,4. Средний возраст диализных пациентов составлял 63 года, стаж диализа -2,8 лет [20]. Тяжелая гиперфосфатемия (> 7 мг/дл) встречалась в 11%, ВГПТ (> 600 пг/мл) -в 18%, (301-600 пг/мл) -в 33%, 150-300 пг/мл -в 31% случаев.…”

“…Этот вывод согласуется с французским когортным исследованием 2010 г., включающим 2008 пациентов на ГД, которое показало, что пожилые пациенты имеют более низкие уровни фосфатов по сравнению с более молодыми пациентами. Этот вывод был объяснен тенденцией пожилых пациентов к снижению костного оборота и снижению потребления белка [20].…”