Improvements in survival after dialysis in the elderly

The majority of patients starting dialysis as a result of chronic kidney disease are 65 years or older at the time of their first treatment, and many are over 75 years.

Dr. Sarbjit Vanita Jassal and colleagues sought to calculate the mean life-expectancy of patients who began dialysis at either 65–74 years of age or at 75 years or more, and to identify where there was any change in survival probability or in the effect of comorbidities (such as diabetes or heart problems) in this patient population over the decade 1990 to 1999.

In this retrospective cohort study of data from the Canadian Organ Replacement Register, the researchers found that survival among 14 512 elderly patients who began dialysis between 1990 and 1999 improved over time, despite their increasing burden of comorbidity. Specifically, patients aged 65–74 years at the start of dialysis experienced a 23% improvement in survival and those aged 75 or more a 15% improvement. The authors conclude that age alone should not be used as a deterrent to initiating dialysis; rather, the decision should be made on an individual basis and other factors taken into account, including comorbidities, functional abilities and overall quality of life.