Rohrich B, Asmus G, von Herrath D, Schaefer K
Is it worth performing kidney replacement therapy on
patients over 80?
Nephrol Dial Transplant
(Dec) 12:2412-2413 1996
At a time when a substantial minority of patients presenting for dialysis
> 80 years of age, it is necessary to look at survivals in this cohort.
authors looked at survivals in 82 patients who were prevalent in their
center between 1981 and 1996. The average survival was 26 months, and
interestingly, was the same for patients aged 80-83 years, 84-86 years, and
92 years at time of commencing dialysis. Overall one and two year
were 30 and 50%. However, when the results were broken up into patients
commencing dialysis before and after 1990, the later patients fared much
with one and two year gross mortality rates of 20 and 40%, respectively.
Comment: The data reinforce the notion that patients who are very
elderly may represent an especially hardy group of individuals. The fact
this clinic had gross mortality in 80+ year olds similar to the crude
of all patients in the US gives one pause. Thirteen of their patients were
diabetic, and these patients had a slightly BETTER survival than their non-
diabetic counterparts. This is either an interesting anomaly, or perhaps
to the fact that diabetes in the extreme elderly may have different
implications than in younger patients.
(John T. Daugirdas, M.D., University of Illinois at Chicago)