Strategies for the Super-Aged Dialysis Population: Survival Benefits or Alternative Goals?

Abstract:

BACKGROUND/AIMS:Japan's aging population has prominent epidemiological and patient characteristics. The number of hemodialysis patients aged ≥70 years is increasing. Age-adjusted mortality is improving, but some cause-specific mortalities remain unchanged, including infectious disease and malignancy, requiring combative strategies. However, survival trends for patients aged 90 years or older are not known. METHODS:We examined annual data reported by the -Japanese Society for Dialysis Therapy Renal Data Registry for the period 1987-2014 to determine survival trends. RESULTS:Survival in the super-aged group (≥90 years) is still mostly unimproved. In terms of cause-specific survival, especially death due to heart failure differs distinctly between this group and the remaining elderly patients, indicating that improving their survival is difficult. Alternative dialysis goals could therefore be considered. The major dialysis objective in this population could be to maintain quality of life and limit functional impairment. CONCLUSION:Survival of the super-aged population has not improved in the last 2 decades. Thus, withholding or withdrawing dialysis and providing conservative management without dialysis treatment could be an important option for patients aged 90 years or older.

journal_name

Blood Purif

journal_title

Blood purification

authors

Sakurai S,Hanafusa N,Nomura T,Tsuchiya K,Nitta K,Nangaku M

doi

10.1159/000496660

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

95-105

eissn

0253-5068

issn

1421-9735

pii

000496660

journal_volume

47 Suppl 2

pub_type

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