Description
Abstract
Background:Old age and associated comorbidities pose serious obstacles to achieving favourable outcomes inhemodialysis patients, which need to be factored in while taking treatment decisions.
Aim:A retrospective observational study of survival and functional status of patients, who had reached 80 years at the time of initiation of chronic maintenance hemodialysis, was done in the nephrology unit of a South Indian tertiary care hospital.
Material & Methods:Baselinedemographics, presence of comorbidities, indications for initiating dialysis andfunctional status of the patient at the time of initiationwere recorded. Survival and functional status of these patients at 3 months and 6 monthsafter initiation were thenrecorded.
Results:In this study 24 (75%) patients were male and 8 (25%) were female. All the 32 (100%) patients had hypertension, while 28 (87.5%), 11 (34.37%) and 5(18.75%) were suffering from diabetes mellitus, coronary artery disease and left ventricular failure respectively. Most common indication for dialysis was pulmonary oedema 15 (46.87%) followed by uremic encephalopathy 6 (18.75%), while uremic pericarditis and metabolic acidosis contributed to initiation of dialysis in 1 patient each (3.12%).In 8 (25%) patients an elevated serum creatinine was the only indication for starting dialysis. The functional status at the time of initiation of dialysis was 13 (40.62%) ambulant patients and 19 (59.37%) partially dependentpatients, while 0 were bedridden. Of these, 19 (59.37%) patients died within 3 months of initiation of dialyisis.Functional status of thepatients at 3 months were ambulant 8 (25%), partially dependent 3 (9.37%) andbedridden 2 (6.25%).At the end of 6 months,a total of 24 (75%) patients were dead.Functional status of the patients at 6 months were ambulant 6 (18.75%), partially dependent 2 (6.25%) andbedridden 0 (0%).
Conclusion:Patientsinitiated onmaintenance hemodialysis after the age of 80 years tend to have very poor outcomes in terms of survival and functional status.
Key words: Renal disease, Haemodialysis, Nephrology,Uremic encephalopathy,Hypertension
