title: Elderly dialysis patients: analysis of factors affecting long-term survival in 4-year prospective observation.
abstract: OBJECTIVE
  To assess factors influencing the long-term survival of elderly dialysis patients.
  
  
  METHODS
  The study group consisted of 51 prevalent dialysis patients aged over 70 years (32 F and 19 M, all caucasians), who had been on a chronic hemodialysis (27) or peritoneal dialysis program (24) for at least 2 months; median age was 77 years, median time on dialysis before inclusion was 16 months, and median residual diuresis was 600 ml. The patients were prospectively followed up to 4 years, and an analysis of factors affecting survival was performed.
  
  
  RESULTS
  Thirteen patients from the initial cohort of 51 (25.5 %) survived the whole 48-month observation period: 10 HD patients (37 %) and 3 PD patients (12.5 %). Annual mortality rate was 28.2 %: 37.4 % on PD vs. 20.9 % on HD. The dialysis modality had a significant impact on patients' survival (p = 0.049; Cox F-test). The independent mortality risk factors in the Cox proportional hazard regression model were higher plasma pro-atrial natriuretic peptide (pro-ANP) (p = 0.006), lower residual diuresis (p = 0.048), and lower systolic blood pressure (BP) value (p = 0.039).
  
  
  CONCLUSIONS
  Paramount for the survival of the elderly on dialysis is adequate extracellular volume control. Residual renal function is a protective factor for the survival of elderly HD patients. This observation is novel, not previously reported in an elderly dialysis population.
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Borowska 213 St., 50-556 Wroclaw, Poland. kmadziarska@wp.pl
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Madziarska
authors.forename: Waclaw
authors.initials: W
authors.lastname: Weyde
authors.forename: Magdalena
authors.initials: M
authors.lastname: Krajewska
authors.forename: Ewa
authors.initials: E
authors.lastname: Zukowska Szczechowska
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Gosek
authors.forename: Jozef
authors.initials: J
authors.lastname: Penar
authors.forename: Renata
authors.initials: R
authors.lastname: Klak
authors.forename: Tomasz
authors.initials: T
authors.lastname: Golebiowski
authors.forename: Cyprian
authors.initials: C
authors.lastname: Kozyra
authors.forename: Marian
authors.initials: M
authors.lastname: Klinger
mesh_terms: D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood; D001794:Blood Pressure; D004231:Diuresis; D005260:Female; D006801:Humans; D007375:Interleukin-1 / Q000097:blood; D007668:Kidney / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D010530:Peritoneal Dialysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis
chemical_list: D007375:Interleukin-1; D009320:Atrial Natriuretic Factor