The clinical status and survival in elderly dialysis: example of the oldest region of France
The number of elderly (≥75 years) patients with end-stage renal disease (ESRD) has increased markedly, including in the Limousin region, which has the oldest population in France. We retrospectively compared outcomes in elderly and non-elderly ESRD patients who started dialysis during two time perio...
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| Veröffentlicht in: | BMC nephrology 2013-06, Vol.14 (1), p.131-131, Article 131 |
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| creator | Glaudet, Florence Hottelart, Carine Allard, Julien Allot, Vincent Bocquentin, Frédérique Boudet, Rémy Champtiaux, Béatrice Charmes, Jean Pierre Ciobotaru, Monica Dickson, Zara Essig, Marie Honoré, Philippe Lacour, Céline Lagarde, Christian Manescu, Maria Peyronnet, Pierre Poux, Jean Michel Rerolle, Jean Philippe Rincé, Michel Couchoud, Cécile Aldigier, Jean Claude |
| description | The number of elderly (≥75 years) patients with end-stage renal disease (ESRD) has increased markedly, including in the Limousin region, which has the oldest population in France. We retrospectively compared outcomes in elderly and non-elderly ESRD patients who started dialysis during two time periods.
Baseline clinical characteristics, care, and survival rates were assessed in 557 ESRD patients aged ≥75 and |
| doi_str_mv | 10.1186/1471-2369-14-131 |
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Baseline clinical characteristics, care, and survival rates were assessed in 557 ESRD patients aged ≥75 and <75 years who started dialysis in 2002-2004 and 2005-2007. Survival curves and Cox proportional hazards model were used to assess survival and factors associated with survival.
Of the 557 patients, 343 and 214 were <75 years and ≥75 years, respectively. Dialysis was started in 2002-2004 and 2005-2007 by 197 and 146 patients <75 years, respectively, and by 96 and 118 patients ≥75 years, respectively. Median age (73.4 years [interquartile range [IQR] 61.7-79.5 years] vs 69.5 years [IQR 57.4-77.4 years] p = 0.001) and the proportion aged ≥75 years (44.7% vs 32.8%, p = 0.004) were significantly higher in 2005-2007 than in 2002-2004. Improved initial status during 2005-2007 was observed only in patients ≥75 years, with a decrease in some co-morbidities, improved walking and better preparation for dialysis. Mortality rates were significantly lower in 2005-2007 than in 2002-2004 (hazard ratio 0.81, 95% confidence interval 0.69-0.95; p = 0.008), with the difference due to factors associated with clinical status and care.
Improved initial clinical status and better preparation for dialysis, accompanied by increased survival, were observed for patients ≥75 years who started dialysis more recently, perhaps because of early referral to a nephrologist.</description><identifier>ISSN: 1471-2369</identifier><identifier>EISSN: 1471-2369</identifier><identifier>DOI: 10.1186/1471-2369-14-131</identifier><identifier>PMID: 23800023</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Age ; Aged ; Aged patients ; Aged, 80 and over ; Care and treatment ; Chronic kidney failure ; Female ; France - epidemiology ; Health aspects ; Health facilities ; Hemodialysis ; Hospitals ; Humans ; Kidney diseases ; Kidney Failure, Chronic - diagnosis ; Kidney Failure, Chronic - mortality ; Kidney Failure, Chronic - therapy ; Life Sciences ; Male ; Medical research ; Medicine, Experimental ; Middle Aged ; Morbidity ; Mortality ; Multivariate analysis ; Nephrology ; Older people ; Patient outcomes ; Peritoneal dialysis ; Pharmaceutical sciences ; Population ; Quality of life ; Renal Dialysis - mortality ; Renal Dialysis - trends ; Retrospective Studies ; Survival analysis ; Survival Rate - trends</subject><ispartof>BMC nephrology, 2013-06, Vol.14 (1), p.131-131, Article 131</ispartof><rights>COPYRIGHT 2013 BioMed Central Ltd.</rights><rights>2013 Glaudet et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><rights>Copyright © 2013 Glaudet et al.; licensee BioMed Central Ltd. 2013 Glaudet et al.; licensee BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b585t-3c7d71d43719a589f90f4d796255663b88dabe151fbd9f34d2b893ea515a70ab3</citedby><cites>FETCH-LOGICAL-b585t-3c7d71d43719a589f90f4d796255663b88dabe151fbd9f34d2b893ea515a70ab3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3694468/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3694468/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23800023$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://unilim.hal.science/hal-00942807$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Glaudet, Florence</creatorcontrib><creatorcontrib>Hottelart, Carine</creatorcontrib><creatorcontrib>Allard, Julien</creatorcontrib><creatorcontrib>Allot, Vincent</creatorcontrib><creatorcontrib>Bocquentin, Frédérique</creatorcontrib><creatorcontrib>Boudet, Rémy</creatorcontrib><creatorcontrib>Champtiaux, Béatrice</creatorcontrib><creatorcontrib>Charmes, Jean Pierre</creatorcontrib><creatorcontrib>Ciobotaru, Monica</creatorcontrib><creatorcontrib>Dickson, Zara</creatorcontrib><creatorcontrib>Essig, Marie</creatorcontrib><creatorcontrib>Honoré, Philippe</creatorcontrib><creatorcontrib>Lacour, Céline</creatorcontrib><creatorcontrib>Lagarde, Christian</creatorcontrib><creatorcontrib>Manescu, Maria</creatorcontrib><creatorcontrib>Peyronnet, Pierre</creatorcontrib><creatorcontrib>Poux, Jean Michel</creatorcontrib><creatorcontrib>Rerolle, Jean Philippe</creatorcontrib><creatorcontrib>Rincé, Michel</creatorcontrib><creatorcontrib>Couchoud, Cécile</creatorcontrib><creatorcontrib>Aldigier, Jean Claude</creatorcontrib><creatorcontrib>REIN Limousin</creatorcontrib><title>The clinical status and survival in elderly dialysis: example of the oldest region of France</title><title>BMC nephrology</title><addtitle>BMC Nephrol</addtitle><description>The number of elderly (≥75 years) patients with end-stage renal disease (ESRD) has increased markedly, including in the Limousin region, which has the oldest population in France. We retrospectively compared outcomes in elderly and non-elderly ESRD patients who started dialysis during two time periods.
Baseline clinical characteristics, care, and survival rates were assessed in 557 ESRD patients aged ≥75 and <75 years who started dialysis in 2002-2004 and 2005-2007. Survival curves and Cox proportional hazards model were used to assess survival and factors associated with survival.
Of the 557 patients, 343 and 214 were <75 years and ≥75 years, respectively. Dialysis was started in 2002-2004 and 2005-2007 by 197 and 146 patients <75 years, respectively, and by 96 and 118 patients ≥75 years, respectively. Median age (73.4 years [interquartile range [IQR] 61.7-79.5 years] vs 69.5 years [IQR 57.4-77.4 years] p = 0.001) and the proportion aged ≥75 years (44.7% vs 32.8%, p = 0.004) were significantly higher in 2005-2007 than in 2002-2004. Improved initial status during 2005-2007 was observed only in patients ≥75 years, with a decrease in some co-morbidities, improved walking and better preparation for dialysis. Mortality rates were significantly lower in 2005-2007 than in 2002-2004 (hazard ratio 0.81, 95% confidence interval 0.69-0.95; p = 0.008), with the difference due to factors associated with clinical status and care.
Improved initial clinical status and better preparation for dialysis, accompanied by increased survival, were observed for patients ≥75 years who started dialysis more recently, perhaps because of early referral to a nephrologist.</description><subject>Age</subject><subject>Aged</subject><subject>Aged patients</subject><subject>Aged, 80 and over</subject><subject>Care and treatment</subject><subject>Chronic kidney failure</subject><subject>Female</subject><subject>France - epidemiology</subject><subject>Health aspects</subject><subject>Health facilities</subject><subject>Hemodialysis</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Kidney diseases</subject><subject>Kidney Failure, Chronic - diagnosis</subject><subject>Kidney Failure, Chronic - mortality</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Nephrology</subject><subject>Older people</subject><subject>Patient outcomes</subject><subject>Peritoneal dialysis</subject><subject>Pharmaceutical sciences</subject><subject>Population</subject><subject>Quality of life</subject><subject>Renal Dialysis - mortality</subject><subject>Renal Dialysis - trends</subject><subject>Retrospective Studies</subject><subject>Survival analysis</subject><subject>Survival Rate - trends</subject><issn>1471-2369</issn><issn>1471-2369</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp1Us9vFCEYJUZj6-rdkyHxooepMMDAeGiy2VhrsomXejMhDDC7NAysMLOx_71Mtq7dpoYD5H3vvY_vBwBvMbrAWDSfMOW4qknTVphWmOBn4PwIPX_wPgOvcr5FCHNB0UtwVhOBEKrJOfh5s7VQexecVh7mUY1ThioYmKe0d_uCuQCtNzb5O2ic8nfZ5c_Q_lbDzlsYezgWg1gIeYTJblwMM3iVVND2NXjRK5_tm_t7AX5cfblZXVfr71-_rZbrqmOCjRXR3HBsKOG4VUy0fYt6anjb1Iw1DemEMKqzmOG-M21PqKk70RKrGGaKI9WRBbg8-O6mbrBG2zAm5eUuuUGlOxmVk6eR4LZyE_eytIbSRhSDjweD7SPZ9XItZwyhltYC8T0u3NWB27n4n2SnER0HOU9CzpMoL1kGVVw-3H85xV9TaZ4cXNbWexVsnLLEjIqG4LrUvwDvH1Fv45RCaWhx4qTmpMH8H2ujvJUu9LEk17OpXDJCGySYmFkXT7DKMXZwOgbbu4KfCNBBoFPMOdn-WChGct7Bp0p793AaR8HfpSN_AFcX1QY</recordid><startdate>20130625</startdate><enddate>20130625</enddate><creator>Glaudet, Florence</creator><creator>Hottelart, Carine</creator><creator>Allard, Julien</creator><creator>Allot, Vincent</creator><creator>Bocquentin, Frédérique</creator><creator>Boudet, Rémy</creator><creator>Champtiaux, Béatrice</creator><creator>Charmes, Jean Pierre</creator><creator>Ciobotaru, Monica</creator><creator>Dickson, Zara</creator><creator>Essig, Marie</creator><creator>Honoré, Philippe</creator><creator>Lacour, Céline</creator><creator>Lagarde, Christian</creator><creator>Manescu, Maria</creator><creator>Peyronnet, Pierre</creator><creator>Poux, Jean Michel</creator><creator>Rerolle, Jean Philippe</creator><creator>Rincé, Michel</creator><creator>Couchoud, Cécile</creator><creator>Aldigier, Jean Claude</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>1XC</scope><scope>5PM</scope></search><sort><creationdate>20130625</creationdate><title>The clinical status and survival in elderly dialysis: example of the oldest region of France</title><author>Glaudet, Florence ; Hottelart, Carine ; Allard, Julien ; Allot, Vincent ; Bocquentin, Frédérique ; Boudet, Rémy ; Champtiaux, Béatrice ; Charmes, Jean Pierre ; Ciobotaru, Monica ; Dickson, Zara ; Essig, Marie ; Honoré, Philippe ; Lacour, Céline ; Lagarde, Christian ; Manescu, Maria ; Peyronnet, Pierre ; Poux, Jean Michel ; Rerolle, Jean Philippe ; Rincé, Michel ; Couchoud, Cécile ; Aldigier, Jean Claude</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b585t-3c7d71d43719a589f90f4d796255663b88dabe151fbd9f34d2b893ea515a70ab3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Age</topic><topic>Aged</topic><topic>Aged patients</topic><topic>Aged, 80 and over</topic><topic>Care and treatment</topic><topic>Chronic kidney failure</topic><topic>Female</topic><topic>France - epidemiology</topic><topic>Health aspects</topic><topic>Health facilities</topic><topic>Hemodialysis</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Kidney diseases</topic><topic>Kidney Failure, Chronic - diagnosis</topic><topic>Kidney Failure, Chronic - mortality</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Nephrology</topic><topic>Older people</topic><topic>Patient outcomes</topic><topic>Peritoneal dialysis</topic><topic>Pharmaceutical sciences</topic><topic>Population</topic><topic>Quality of life</topic><topic>Renal Dialysis - mortality</topic><topic>Renal Dialysis - trends</topic><topic>Retrospective Studies</topic><topic>Survival analysis</topic><topic>Survival Rate - trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Glaudet, Florence</creatorcontrib><creatorcontrib>Hottelart, Carine</creatorcontrib><creatorcontrib>Allard, Julien</creatorcontrib><creatorcontrib>Allot, Vincent</creatorcontrib><creatorcontrib>Bocquentin, Frédérique</creatorcontrib><creatorcontrib>Boudet, Rémy</creatorcontrib><creatorcontrib>Champtiaux, Béatrice</creatorcontrib><creatorcontrib>Charmes, Jean Pierre</creatorcontrib><creatorcontrib>Ciobotaru, Monica</creatorcontrib><creatorcontrib>Dickson, Zara</creatorcontrib><creatorcontrib>Essig, Marie</creatorcontrib><creatorcontrib>Honoré, Philippe</creatorcontrib><creatorcontrib>Lacour, Céline</creatorcontrib><creatorcontrib>Lagarde, Christian</creatorcontrib><creatorcontrib>Manescu, Maria</creatorcontrib><creatorcontrib>Peyronnet, Pierre</creatorcontrib><creatorcontrib>Poux, Jean Michel</creatorcontrib><creatorcontrib>Rerolle, Jean Philippe</creatorcontrib><creatorcontrib>Rincé, Michel</creatorcontrib><creatorcontrib>Couchoud, Cécile</creatorcontrib><creatorcontrib>Aldigier, Jean Claude</creatorcontrib><creatorcontrib>REIN Limousin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMC nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Glaudet, Florence</au><au>Hottelart, Carine</au><au>Allard, Julien</au><au>Allot, Vincent</au><au>Bocquentin, Frédérique</au><au>Boudet, Rémy</au><au>Champtiaux, Béatrice</au><au>Charmes, Jean Pierre</au><au>Ciobotaru, Monica</au><au>Dickson, Zara</au><au>Essig, Marie</au><au>Honoré, Philippe</au><au>Lacour, Céline</au><au>Lagarde, Christian</au><au>Manescu, Maria</au><au>Peyronnet, Pierre</au><au>Poux, Jean Michel</au><au>Rerolle, Jean Philippe</au><au>Rincé, Michel</au><au>Couchoud, Cécile</au><au>Aldigier, Jean Claude</au><aucorp>REIN Limousin</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The clinical status and survival in elderly dialysis: example of the oldest region of France</atitle><jtitle>BMC nephrology</jtitle><addtitle>BMC Nephrol</addtitle><date>2013-06-25</date><risdate>2013</risdate><volume>14</volume><issue>1</issue><spage>131</spage><epage>131</epage><pages>131-131</pages><artnum>131</artnum><issn>1471-2369</issn><eissn>1471-2369</eissn><abstract>The number of elderly (≥75 years) patients with end-stage renal disease (ESRD) has increased markedly, including in the Limousin region, which has the oldest population in France. We retrospectively compared outcomes in elderly and non-elderly ESRD patients who started dialysis during two time periods.
Baseline clinical characteristics, care, and survival rates were assessed in 557 ESRD patients aged ≥75 and <75 years who started dialysis in 2002-2004 and 2005-2007. Survival curves and Cox proportional hazards model were used to assess survival and factors associated with survival.
Of the 557 patients, 343 and 214 were <75 years and ≥75 years, respectively. Dialysis was started in 2002-2004 and 2005-2007 by 197 and 146 patients <75 years, respectively, and by 96 and 118 patients ≥75 years, respectively. Median age (73.4 years [interquartile range [IQR] 61.7-79.5 years] vs 69.5 years [IQR 57.4-77.4 years] p = 0.001) and the proportion aged ≥75 years (44.7% vs 32.8%, p = 0.004) were significantly higher in 2005-2007 than in 2002-2004. Improved initial status during 2005-2007 was observed only in patients ≥75 years, with a decrease in some co-morbidities, improved walking and better preparation for dialysis. Mortality rates were significantly lower in 2005-2007 than in 2002-2004 (hazard ratio 0.81, 95% confidence interval 0.69-0.95; p = 0.008), with the difference due to factors associated with clinical status and care.
Improved initial clinical status and better preparation for dialysis, accompanied by increased survival, were observed for patients ≥75 years who started dialysis more recently, perhaps because of early referral to a nephrologist.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>23800023</pmid><doi>10.1186/1471-2369-14-131</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Age Aged Aged patients Aged, 80 and over Care and treatment Chronic kidney failure Female France - epidemiology Health aspects Health facilities Hemodialysis Hospitals Humans Kidney diseases Kidney Failure, Chronic - diagnosis Kidney Failure, Chronic - mortality Kidney Failure, Chronic - therapy Life Sciences Male Medical research Medicine, Experimental Middle Aged Morbidity Mortality Multivariate analysis Nephrology Older people Patient outcomes Peritoneal dialysis Pharmaceutical sciences Population Quality of life Renal Dialysis - mortality Renal Dialysis - trends Retrospective Studies Survival analysis Survival Rate - trends |
| title | The clinical status and survival in elderly dialysis: example of the oldest region of France |
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