RENAL REPLACEMENT THERAPY IN THE ELDERLY

Background and Methods: In a retrospective study the medical records o f 122 patients aged over 65 years at the start of renal replacement th erapy (RRT) in our dialysis centre were analysed. Results: The mean ag e at the start of RRT was 72.7 +/- 5.7 years (range 65.0-90.3). Sevent y-six percent were treated with haemodialysis, 21% with haemofiltratio n and 3% with continuous ambulatory peritoneal dialysis. There was no significant difference in survival between the different modes of trea tment. The median survival was 23.8 months, the actuarial survival rat es at 2, 5 and 7 years were 50, 27 and 18%, respectively. Patients age d between 65 and 75 years had a median survival of 36.4 months, patien ts above 75 years of 12.5 months (P = 0.009). Patients with tubulo-int erstitial nephritis had a significantly longer survival than patients with other renal diseases. When chronic obstructive pulmonary disease or peripheral vascular disease was present, there was a significantly shorter survival. There was no difference in survival between patients with malignancy, cardiac diseases, diabetes mellitus or cerebrovascul ar diseases before the start of RRT and others. After the start of RRT there was a significant increase of infectious and psychiatric diseas e. During the study period 70% died, most frequently from cardiovascul ar causes (28%), discontinuation of dialysis treatment (28%) or infect ion (19%). Conclusions: We think that both survival and quality of lif e in elderly patients during RRT are acceptable, and that neither age nor comorbidity should be a contraindication to RRT.